title: Inferior vena cava filter retrieval: effectiveness and complications of routine and advanced techniques.
abstract: OBJECTIVE
  To investigate the success and safety of routine versus advanced inferior vena cava (IVC) filter retrieval techniques.
  
  
  METHODS
  A retrospective review was performed of patients who underwent IVC filter placement and/or a retrieval attempt over a 10-year period. Retrieval technique(s), preretrieval computed tomography, preretrieval venography, and clinical/imaging follow-up for 30 days after retrieval were analyzed. Mean filter dwell time was 134 days (range, 0-2,475 d).
  
  
  RESULTS
  Filter retrieval was attempted 231 times in 217 patients (39% female, 61% male; mean age, 50.7 y), with success rates of 73.2% (169 of 231) and 94.7% (54 of 57) for routine and advanced filter retrieval techniques, respectively. The overall filter retrieval complication rate was 1.7% (four of 231); complications in four patients (with multiple complications in some cases) included IVC dissection, IVC intussusception, IVC thrombus/stenosis, filter fracture with embedded strut, IVC injury with hemorrhage, and vascular injury from complicated venous access. The rate of complications associated with filter retrievals that required advanced technique was significantly higher than seen with routine technique (5.3% vs 0.4%; P < .05). Longer dwell time, more transverse tilt, and presence of an embedded hook were associated with significantly increased rates of failed retrieval via routine technique (P < .05).
  
  
  CONCLUSIONS
  IVC filters can be retrieved with a high overall success rate (98.2%) and a low complication rate (1.7%) by using advanced techniques when the routine approach has failed; however, the use of advanced techniques is associated with a significantly higher complication rate.
authors.affiliation: Department of Radiology, Division of Interventional Radiology, University of California, Los Angeles, 757 Westwood Plaza, Suite 2125C, Los Angeles, CA 90095.
authors.forename: Ramsey
authors.initials: R
authors.lastname: Al-Hakim
authors.affiliation: Department of Radiology, Division of Interventional Radiology, University of California, Los Angeles, 757 Westwood Plaza, Suite 2125C, Los Angeles, CA 90095.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Kee
authors.affiliation: Department of Radiology, Division of Interventional Radiology, University of California, Los Angeles, 757 Westwood Plaza, Suite 2125C, Los Angeles, CA 90095.
authors.forename: Kristen
authors.initials: K
authors.lastname: Olinger
authors.affiliation: Department of Radiology, Division of Interventional Radiology, University of California, Los Angeles, 757 Westwood Plaza, Suite 2125C, Los Angeles, CA 90095.
authors.forename: Edward W
authors.initials: EW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Division of Interventional Radiology, University of California, Los Angeles, 757 Westwood Plaza, Suite 2125C, Los Angeles, CA 90095.
authors.forename: John M
authors.initials: JM
authors.lastname: Moriarty
authors.affiliation: Department of Radiology, Division of Interventional Radiology, University of California, Los Angeles, 757 Westwood Plaza, Suite 2125C, Los Angeles, CA 90095. Electronic address: jumcwilliams@mednet.ucla.edu.
authors.forename: Justin P
authors.initials: JP
authors.lastname: McWilliams
mesh_terms: D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D019919:Prosthesis Implantation / Q000295:instrumentation*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging