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An analysis of factors associated with increased fluoroscopy time or the need for complex techniques at IVC filter retrieval

  • Mark Kleedehn
  • Kelli Moore
  • Katherine Longo
  • Kaitlin Woo
  • Paul Laeseke
Interventional

Abstract

Objectives

To evaluate factors associated with increased fluoroscopy time or the need for complex techniques at IVC filter retrieval.

Methods

This is a single-institution retrospective cohort study of 187 consecutive patients who underwent IVC filter retrieval. An analysis was performed on associations of patient factors with increased fluoroscopy time and/or the need for complex retrieval techniques. A complex retrieval was defined as one requiring more than standard sheath and snare technique.

Results

Access vein during filter placement was not associated with filter tilt at placement or removal (p = 0.61 and 0.48). Neither the direction of the hook nor its relationship to the tilt was associated with the need for complex retrieval or increased retrieval fluoroscopy time (p = 0.25, 0.23, p = 0.18, 0.23). Tilt angle at placement correlated with hook apposition at time of removal (p = 0.01). Hook apposition was associated with complex retrieval and increased fluoroscopy time (p < 0.01). Larger tilt angle at placement was not associated with complex retrieval (p = 0.22), but a larger angle at removal was (p < 0.01). Longer dwell time correlated with the need for complex retrieval (p = 0.02). Filter type, sex, and age were not associated with complex retrievals (p = 0.58, p = 0.90, p = 0.99).

Conclusion

Contrary to previous hypotheses and studies, access vein for filter placement did not affect filter tilting, and direction of filter hook–tilt relationship did not affect retrieval fluoroscopy time or the need for complex retrieval techniques. Increased filter placement angle was associated with a larger angle at removal and hook–wall apposition, both of which were associated with complex retrievals.

Key Points

Filter hook orientation did not correlate with retrieval complexity.

Filter insertion vein did not correlate with filter tilt.

Filter tilt and hook apposition to the caval wall at the time of retrieval correlated with retrieval procedure complexity.

Keywords

Vena cava filters Fluoroscopy Radiology, interventional 

Abbreviations

CPT

Current procedural terminology

DVT

Deep venous thrombosis

FDA

US Food and Drug Administration

IVC

Inferior vena cava

PA

Posteroanterior

PE

Pulmonary embolism

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr. Mark Kleedehn.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Kaitlin Woo has kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in abstract form in JVIR.

Methodology

• Retrospective

• Observational

• Performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of WisconsinMadisonUSA
  2. 2.Department of Biostatistics and Medical InformaticsUniversity of WisconsinMadisonUSA

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