Hilary A. Brazeal MD, Presenter: Nothing to Disclose

Jay Desai MD, Abstract Co-Author: Nothing to Disclose

Carlos Javier Guevara MD, Abstract Co-Author: Nothing to Disclose

Seung Kwon Kim MD, Abstract Co-Author: Nothing to Disclose

 Prophylactic IVC (inferior vena cava) filter placement was initiated for all "high-risk" spinal surgery patients after a pilot study demonstrated decreased VTE-related morbidity and mortality . Given increased angulation of the IVC filter in patients with scoliosis, there is higher chance of IVC filter tilting, leading to increased difficulty of IVC filter retrieval. The purpose of this study is to compare filter retrieval between scoliosis and non-scoliosis patients who had temporary IVC filter placement before major spinal reconstructive surgery.

Patients were identified by a computerized search of the radiology information system for prophylactic temporary IVC filter placement before major spinal reconstructive surgery and filter retrieval after surgery from 2005 to Jan 2014. These patients were divided into two groups: a scoliosis surgery (SS) group and a non-scoliosis surgery (NSS) group. Type of filter, attempted filter retrieval, indwelling time of filter, sedation time of the filter retrieval procedure, and success of attempted filter retrieval were compared between the two groups.

From 2005 to Jan 2014, 134 IVC filters were placed prior to spine surgery. 116 (84.9%) of those were retrievable filters. Retrieval was attempted on 53 (45.7%) of the retrievable filters. Retrieval was successful in 45/53 (84.9%) of those attempts, including a single case that was successful on the second attempt. Indwelling time of IVC filter at time of attempted retrieval was significantly higher in the SS group (SS group = 59.4 days, NSS group = 31 days) (p=0.006). Success rate of attempted filter retrieval in the SS group (78.1% (25/32)) was lower than the NSS group (95.2% (20/21)) (p=0.13). Average retrieval sedation time of a successful retrieval in the SS group (44.8 minutes) was higher than the NSS group (28.2 minutes) (p= 0.15). Type of filters in failed retrievals were Günther Tulip (4/25) and Option (4/17).

IVC filter retrieval requires increased procedure time and has decreased success rates in the SS group compared with the NSS group.

Longer IVC filter indwelling time in scoliosis surgery patients leads to increased difficulty and decreased success of IVC filter retrieval.

Brazeal, H, Desai, J, Guevara, C, Kim, S, Prophylactic Temporary IVC Filter Retrieval following Major Spinal Reconstruction Surgery: Comparison between Scoliosis and Non-scoliosis Patients.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045483.html