Predicting inferior vena cava (IVC) filter retrievability using positional parameters: A comparative study of various filter types

Abstract

Purpose: To compare changes in inferior vena cava (IVC) filter positional parameters from insertion to removal and examine how they affect retrievability amongst various filter types.

Materials and methods: A total of 447 patients (260 men, 187 women) with a mean age of 55 years (range: 13-91 years) who underwent IVC filter retrieval between 2007-2014 were retrospectively included. Post-insertion and pre-retrieval angiographic studies were assessed for filter tilt, migration, strut wall penetration and retrieval outcomes. ANCOVA and multiple logistic regression models were used to analyze factors affecting retrieval success. Pairwise comparisons between filter types were performed.

Results: Of 488 IVC filter retrieval attempts, 94.1% were ultimately successful. The ALN filter had the highest mean absolute value of tilt (5.6 degrees), the Optease filter demonstrated the largest mean migration (-8.0mm) and the Bard G2 filter showed highest mean penetration (5.2mm). Dwell time of 0-90 days (OR, 11.1; P=0.01) or 90-180 days (OR, 2.6; P=0.02), net tilt of 10-15 degrees (OR 8.9; P=0.05), caudal migration of -10 to 0mm (OR, 3.46; P=0.03) and penetration less than 3mm (OR, 2.6; P=0.01) were positive predictors of successful retrievability. Higher odds of successful retrieval were obtained for the Bard G2X, Bard G2 and Cook Celect when compared to the ALN and Cordis Optease filters.

Conclusion: Shorter dwell time, lower mean tilt, caudal migration and less caval wall penetration are positive predictors of successful IVC filter retrieval.

Keywords: Inferior vena cava (IVC) filter positional parameters; Inferior vena cava (IVC) filter retrieval; Inferior vena cava (IVC) filters; Thromboprophylaxis.