Endovascular retrieval of a fractured Optease inferior vena cava filter using endobronchial forceps and intraoperative cone-beam computed tomography guidance

Peter J Osztrogonacz; Leena Munawar; Philip Auyang; Ponraj Chinnadurai; Alan B Lumsden

doi:10.1016/j.jvscit.2023.101187

Endovascular retrieval of a fractured Optease inferior vena cava filter using endobronchial forceps and intraoperative cone-beam computed tomography guidance

J Vasc Surg Cases Innov Tech. 2023 Apr 12;9(3):101187. doi: 10.1016/j.jvscit.2023.101187. eCollection 2023 Sep.

Authors

Peter J Osztrogonacz^{1

2}, Leena Munawar¹, Philip Auyang¹, Ponraj Chinnadurai^{1

3}, Alan B Lumsden¹

Affiliations

¹ Department of Cardiovascular Surgery, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX.
² Department of Vascular and Endovascular Surgery, Semmelweis University, Budapest, Hungary.
³ Siemens Medical Solutions USA Inc, Malvern, PA.

Abstract

Endovascular retrieval of fractured inferior vena cava (IVC) filters after the manufacturer recommended indwelling time can be challenging and require advanced retrieval techniques. We describe an endovascular retrieval technique of a fractured Optease IVC filter in a 57-year-old woman using endobronchial forceps and intraoperative cone-beam computed tomography guidance. Following incomplete filter retrieval, the location and orientation of fractured strut was confirmed by cone-beam computed tomography venography. The embedded filter fragment was then successfully removed using endobronchial forceps via a transjugular venous approach. In the present report, we highlight the additional value of intraoperative cross-sectional imaging, in conjunction with advanced endovascular techniques, for retrieval of challenging IVC filters.

Keywords: Endobronchial forceps; Fragmented IVC filter; Image guidance; Intraoperative cone-beam computed tomography; Optease; Pulmonary embolism; Retrievable IVC filter; Venous thromboembolism.

Publication types

Case Reports