title: Safety and efficacy of the Gunther Tulip retrievable vena cava filter: midterm outcomes.
abstract: OBJECTIVE
  To evaluate of the medium-term integrity, efficacy, and complication rate associated with the Gunther Tulip vena cava filter.
  
  
  METHODS
  A retrospective study was performed of 369 consecutive patients who had infrarenal Gunther Tulip inferior vena cava filters placed over a 5-year period. The mean patient age was 61.8 years, and 59% were men. Venous thromboembolic disease and a contraindication to or complication of anticoagulation were the indications for filter placement in 86% of patients; 14% were placed for prophylaxis in patients with a mean of 2.3 risk factors. Follow-up was obtained by review of medical and radiologic records.
  
  
  RESULTS
  Mean clinical follow-up was 780 days. New or recurrent pulmonary embolus occurred in 12 patients (3.3%). New or recurrent deep-vein thrombosis occurred in 53 patients (14.4%). There were no symptomatic fractures, migrations, or caval perforations. Imaging follow-up in 287 patients (77.8%) at a mean of 731 days revealed a single (0.3%) asymptomatic fracture, migration greater than 2 cm in 36 patients (12.5%), and no case of embolization. Of 122 patients with CT scans, asymptomatic perforations were identified in 53 patients (43.4%) at a mean 757 days.
  
  
  CONCLUSIONS
  The Gunther Tulip filter was safe and effective at 2-year follow-up. Complication rates were similar to those reported for permanent inferior vena cava filters.
authors.affiliation: Department of Radiology, Section of Vascular and Interventional Radiology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. eric.k.hoffer@hitchcock.org
authors.forename: Eric K
authors.initials: EK
authors.lastname: Hoffer
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Mueller
authors.forename: Marcus R
authors.initials: MR
authors.lastname: Luciano
authors.forename: Nicole N
authors.initials: NN
authors.lastname: Lee
authors.forename: Anne T
authors.initials: AT
authors.lastname: Michaels
authors.forename: John M
authors.initials: JM
authors.lastname: Gemery
mesh_terms: D000046:Academic Medical Centers; D015331:Cohort Studies; D016001:Confidence Intervals; D020878:Device Removal / Q000379:methods*; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011655:Pulmonary Embolism / Q000401:mortality / Q000517:prevention & control*; D015641:Radiography, Interventional; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D017751:Safety Management; D013997:Time Factors; D016896:Treatment Outcome; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000401:mortality / Q000517:prevention & control*