134 - Evidence-Based Review of IVC Filter First Retrieval Attempt Success Rates: Current Data and Future Directions

Mina Makary, MD – Physician, Clinical Associate Professor of Radiology, Ohio State University Wexner Medical Center

Purpose: IVC Filters have been a vital component in PE prophylaxis for over 50 years. Their usage in medical practice has seen a dramatic increase in the past 30 years; as of 2012 there have been an estimated 259,000 filters placed annually. As such, there has been increased attention on filter retrieval techniques and subsequent outcomes, with increasingly large numbers of studies being performed on the subject. In this review, several commonly used IVC filters will be evaluated for their first retrieval attempt success rate.

Material and Methods: A review of the current literature evaluating the performance of various commonly used IVC filters was conducted, with a focus on studies conducted within the past 20 years. From the reviewed studies, data regarding first retrieval attempt success rates and associated dwell times was compiled for several IVC filters. In particular, filter data was reviewed for the ALN (ALN Implants, Chirurgicaux Ghisonaccia, France), the Option Select (Argon Medical Devices Inc, Plano, TX), the Gunther Tulip (Cook Medical, Bloomington, IN), the Denali (CR Bard, Murray Hill, NJ), the Cordis OptEase (Cordis Corp, Hialeah, FL), and the Celect Platinum (Cook Medical, Bloomington, IN).

Results: The success rate for removal of different IVC filters is reliant on a number of factors, including but not limited to dwell time, physician skill, retrieval technique used, and filter tilt after placement. Of the evaluated filters, the Cordis OptEase appeared to have the highest first retrieval attempt success rate; a study conducted by Olivia et. al showed a 100% success rate in the first retrieval attempt when performed within 14 days. For longer dwell times, studies suggest the Denali and Celect Platinum filters both had comparably high first retrieval attempt success rates; numerous studies found success rates for both to be over 94%. Studies evaluating the other investigated filters suggested lower first retrieval attempt success rates.

Conclusions: In the short term, the Cordis OptEase appeared to have the highest retrieval success rates; in longer dwell times, the Denali and Celect Platinum filters proved more successful. Studies directly evaluating retrieval rates and filter tilting could provide more clarity on the superiority of one over the other. In general, more testing with standardized dwell times must be performed before a conclusion can be made in favor of any one filter.