Methods and technical skills for complicated filter retrieval of retrievable inferior vena cava filter: an analysis of 29 cases
Objective: To investigate the methods and technical skills for complicated filter retrieval of the retrievable inferior vena cava filter (IVCF). Methods: The data of 29 patients with lower extremity deep vein thrombosis (DVT) undergoing complicated filter retrieval were analyzed. All patients underwent venography first to assess the status of the filter. In patients with the retrieval hook engaged to the vessel wall, IVCF retrieval was performed by using pigtail catheter assistance, guidewire looping and stirring techniques, bidirectional guidewire, and gooseneck snare catheter combined with guidewire looping, respectively; in those with thrombus in the inferior vena cava, a new filter was placed into the inferior vena if necessary, and then the filters were retrieved after thrombolysis and thrombus extraction. Results: IVCF retrieval was successfully performed in 24 patients, was unsucessful in one patient and was abandoned in 4 patients, and the retrieval rate was 83.9%. No complications such as inferior vena cava rupture and pulmonary embolism occurred during operation. The retrieved filters were noted to be intact with no fractures. Follow-up was conducted for a period of at least 6 months after treatment, and the inferior vena cavae were patent, with no thrombus formation and no obvious fluid collections in the abdominal cavity. Conclusion: The methods of use of catheter, guidewire and gooseneck snare assistance, as well as thrombolysis and thrombus extraction can increase the retrieval rate of the complicated retrievable IVCF retrieval, and thereby, reduced complications caused by long-term filter retention.