Jorge Enrique Lopera MD, Presenter: Nothing to Disclose

Scott G. Smith DO, Abstract Co-Author: Nothing to Disclose

Darlene Sanchez MS, Abstract Co-Author: Nothing to Disclose

Ghazwan M. Faozi Kroma MD, Abstract Co-Author: Nothing to Disclose

Rajeev Suri MD, Abstract Co-Author: Nothing to Disclose

To study if tilting of the Option filter is related to the access route (femoral vs jugular ) , and to determine if the maneuver of rotating the delivery sheath is helpful to prevent filter tilting.

An in-vitro model of the  inferior vena cava (IVC) and ileofemoral system was created by placing a 22 mm PTFE graft inside a bifurcated plastic tubing . The system was connected to an extracorporeal circulation pump running warmed saline at 6.7 lits/min. The Option IVC filter was deployed using a superior (jugular) and inferior right (femoral) approach. Femoral filter deployment was repeated using the maneuver of rotating the deployment sheath under fluoroscopic guidance to displace the tip of the filter away from the IVC wall. The final position of the tip of the filter was measured . Filter tilting was classified as: Touching the wall (T). Severely tilted (ST): tip < 5mm from the wall. Mildly tilted (MT) : tip > 5mm from the wall, and Centered (C).

The filter was deployed using a superior approach 20 times  (T: 3, ST: 4, MT:8 , C: 5). Using a right inferior approach the filter was deployed 13 times with no maneuvers (T: 8, ST: 4 MT: 1,  C:0) ; and 26 times using the rotating maneuver (T: 11, ST: 13, MT: 2,and C: 0). The filter tended to tilt severely toward the left IVC wall when a right inferior approach was used. Using the rotation manuever, the filter still tilted frequently in an anterio-posterior direction .

In this in-vitro model, tilting of the Option filter is more common with the inferior (femoral) than the superior( jugular)  approach. The maneuver of rotating the sheath during filter deployment did not prevent significant filter tilting.

IVC filter tilting can result in decrease filtration ability and difficulties with retrieval . In this in-vitro model , the Option filter tilted significantly more with the femoral approach .

Lopera, J, Smith, S, Sanchez, D, Kroma, G, Suri, R, Tilting of the Option Filter: Femoral vs Jugular Approach.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034187.html