Dominic Semaan MD, JD, Presenter: Nothing to Disclose

Matthew Osher MD, Abstract Co-Author: Nothing to Disclose

Ashish Vyas MD, Abstract Co-Author: Nothing to Disclose

Aaron Joseph Burgin MD, Abstract Co-Author: Nothing to Disclose

Roger L. Gonda MD, Abstract Co-Author: Nothing to Disclose

Laurie Marie Vance MD, Abstract Co-Author: Nothing to Disclose

The purpose of our review is to determine the incidence of complications related to IVC filter placement, as well as to determine which type of IVC filters have the greatest incidence of complications, utilizing subsequent post-deployment computed tomography.  

A retrospective analysis was performed of all IVC filters placed at our institution between 6/1/2010 and 6/21/2013, including the medical records and related imaging. This query totaled 621 filters deployed by our department, of which 188 of those filters had subsequent computed tomography performed at our institution. The incidence of IVC filter brand, caval penetration, migration and strut fracture was recorded. The incidence of IVCF caval penetration was determined pursuant to the SIR practice guidelines.

A total of 188 filters were reviewed. Of those, 88 (36.2%) had caval penetration, 3 migrated from original placement, 3 filters had a fractured strut. Major caval penetration into adjacent viscera/aorta was seen in 6 of the filters deployed. Incidentally, 3 patients developed caval thrombosis. Chi-square analysis demonstrated a statically significant difference in the incidence of caval penetration between the various filters deployed (p= < .001). Of the various types of filters utilized by our institution (Günther Tulip N=28, Celect N=47, Option N=97, Trapese N=10, Eclipse N=2), the Günther Tulip demonstrated the greatest incidence of caval penetration at 71.4%. While only 32.0% of Option filters demonstrated caval penetration, two filters had struts penetrate into the adjacent aorta. The Option demonstrated the highest incidence of migration, with 2 (2.1%) filters averaging 2.4 cm of cephalic migration. Two Celect and one Trapese filter had fractured struts, which could potentially serve as a source of future embolism.  

Interventional radiologists must be evermore cognizant of potential risks of filter deployment. IVC filter placement is not a benign procedure and carries risk to the patient, both intra- and post-procedural. Patients and referring physicians should be educated regarding these risks and the decision to implant an IVC filter, often for the remainder of the patient's life, is not one that should be taken lightly.  

IVC filter placement must be carefully evaluated prior to filter placement, to determine if the risks (including caval penetration) are outweighed by the benefits.

Semaan, D, Osher, M, Vyas, A, Burgin, A, Gonda, R, Vance, L, Complications Related to Inferior Vena Cava Filters: A Retrospective Analysis Utilizing Computed Tomography.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14001248.html