Complications of Retrievable Inferior Vena Cava Filters: A Retrospective Comparison of Denali and Option-ELITE Filters

Abstract

Purpose To compare the complication rate of the Denali and Option-ELITE inferior vena cava (IVC) filters.

Materials and Methods All patients who had a Denali or Option-ELITE IVC filter placed between March 2014 and March 2016 were retrospectively identified from the electronic medical records. Of the 245 IVC filters placed, the positions of 93 devices (21 Denali and 72 Option-ELITE) were documented on follow-up computed tomography (CT) examinations obtained for reasons unrelated to filter placement. In situations where multiple CT studies were obtained after placement, each study was reviewed, for a total of 200 examinations. Images were assessed for filter complication including caval wall penetration by filter components, associated damage to pericaval tissues, filter tilt, migration, and fracture.

Results Penetration of at least one strut was observed in 13% of all filters imaged by CT, (Denali: 14%; Option-ELITE: 13%; p = 1.00). No patients had damage to pericaval tissues or documented symptoms attributed to penetration. Neither the Denali nor the Option-ELITE filters demonstrated significant tilt (> 15 degrees of tilt), migration, or fracture. Compared with Denali; the Option-ELITE filter demonstrated an increasing strut penetration rate with longer indwell times (z = –3.67, p < 0.01).

Conclusions No significant difference was observed between the rates of caval penetration of the Denali and Option-ELITE IVC filters assessed by CT. Additionally, no findings of filter fracture or migration were noted, suggesting that the Denali filter is non-inferior to the Option-ELITE filter with respect to penetration, fracture, tilt, and migration. The Option-ELITE filter demonstrated a time-dependent tendency toward greater strut penetration with longer indwell times.

Keywords

IVC filter - venous thromboembolism - retrievable filters

• References

• 1 Jia Z, Wu A, Tam M, Spain J, McKinney JM, Wang W. Caval penetration by inferior vena cava filters: a systematic literature review of clinical significance and management. Circulation 2015; 132 (10) 944-952
• 2 Mismetti P, Rivron-Guillot K, Quenet S. et al. A prospective long-term study of 220 patients with a retrievable vena cava filter for secondary prevention of venous thromboembolism. Chest 2007; 131 (01) 223-229
• 3 Olorunsola OG, Kohi MP, Fidelman N. et al. Caval penetration by retrievable inferior vena cava filters: a retrospective comparison of Option and Günther Tulip filters. J Vasc Interv Radiol 2013; 24 (04) 566-571
• 4 Bos AS, Tullius T, Patel M. et al. Indwelling and retrieval complications of denali and celect infrarenal vena cava filters. J Vasc Interv Radiol 2016; 27 (07) 1021-1026
• 5 Stavropoulos SW, Chen JX, Sing RF. et al; DENALI Trial Investigators. Analysis of the final DENALI trial data: a prospective, multicenter study of the denali inferior vena cava filter. J Vasc Interv Radiol 2016; 27 (10) 1531-1538.e1
• 6 Tsui B, An T, Moon E, King R, Wang W. Retrospective review of 516 implantations of option inferior vena cava filters at a single health care system. J Vasc Interv Radiol 2016; 27 (03) 345-353
• 7 Oh JC, Trerotola SO, Dagli M. et al. Removal of retrievable inferior vena cava filters with computed tomography findings indicating tenting or penetration of the inferior vena cava wall. J Vasc Interv Radiol 2011; 22 (01) 70-74
• 8 Wang W, Spain J, Tam MD. Acute abdominal pain after retrievable inferior vena cava filter insertion: case report of caval perforation by an option filter. Cardiovasc Intervent Radiol 2011; 34 (04) 883-885
• 9 Kuo WT, Robertson SW. Bard Denali inferior vena cava filter fracture and embolization resulting in cardiac tamponade: a device failure analysis. J Vasc Interv Radiol 2015; 26 (01) 111-5.e1
• 10 Kuo WT, Robertson SW, Odegaard JI, Hofmann LV. Complex retrieval of fractured, embedded, and penetrating inferior vena cava filters: a prospective study with histologic and electron microscopic analysis. J Vasc Interv Radiol 2013; 24 (05) 622-630.e1 quiz 631
• 11 Tse G, Cleveland T, Goode S. Ten-year experience of retrievable inferior vena cava filters in a tertiary referral center. Diagn Interv Radiol 2017; 23 (02) 144-149
• 12 Al-Hakim R, Kee ST, Olinger K, Lee EW, Moriarty JM, McWilliams JP. Inferior vena cava filter retrieval: effectiveness and complications of routine and advanced techniques. J Vasc Interv Radiol 2014; 25 (06) 933-939 quiz 940
• 13 Angel LF, Tapson V, Galgon RE, Restrepo MI, Kaufman J. Systematic review of the use of retrievable inferior vena cava filters. J Vasc Interv Radiol 2011; 22 (11) 1522-1530.e3