According to a study published in Radiology, an online medical journal, the most common reason behind failed inferior vena cava (IVC) filter removal is a tilted filter. When tilted, the IVC filter tip becomes embedded in the wall of the IVC, rendering the filter impossible to retrieve using cone device or loop-snare method.
An IVC filter is a cage-like device inserted into the inferior vena cava, the largest vein in the body. The filters are designed to catch blood clots and are used often in patients that cannot tolerate anticoagulation medication. But the device has been known to migrate, tilt, and perforate the vein and other organs. They’ve also been known to fracture, causing metal wires to work their way through the bodies of the patients.
The researchers, a team of doctors from Perelman School of Medicine at the University of Pennsylvania, studied 144 adult patients who came to Hospital of the University of Pennsylvania between January 2005 and April 2014 for IVC filter retrieval with the tip embedded. According to the Penn Medicine team, the endobronchial forceps technique was able to do what the other retrieval methods couldn’t.
“Endobronchial forceps was successful in 97 percent of patients who presented to our institution with tip-embedded IVC filters,” the study’s lead author S. William Stavropoulos, MD, professor of Radiology, said. “This method offers many patients a new, safe option for retrievable IVC filter removal when standard methods are not possible. This in turn allows more patients to have their filter successfully removed instead of leaving them in place permanently.”
The Penn interventional radiologists were motivated by the strong need to find a new retrieval technique after standard methods using the cone or snare failed again and again with tip-embedded filters.
Device manufacturers such as C.R. Bard, Cordis (a subsidiary of Johnson & Johnson), Rex Medical and Cook Medical are facing more than 1,500 lawsuits for injuries and deaths linked to the filters.