Subscribe to RSS
DOI: 10.1055/s-0041-1727102
Over-the-Wire Inferior Vena Cava Filter Placement: How We Do It
Inferior vena cava (IVC) filter placement is routinely performed in selected clinical settings to protect patients from thromboembolism to the lungs. The absolute indications for IVC filter placement include patients who have failed or have absolute contraindications to anticoagulation in the setting of acute venous thromboembolic disease (VTE), such as pulmonary embolism (PE) and deep vein thrombosis (DVT). The relative indications are variable based on society guidelines and include patients who are candidates for anticoagulation but have large free-floating proximal DVT or poor cardiopulmonary reserve. Along with the expansion of relative indications, the advent of retrievable IVC filter has also led to a significant growth in the number of filter placements in previous years. Overall from 1993 to 2010, the number of annual filter placement increased from 28,000 to 130,000, representing a 358% increase.[1] In the subsequent years, the filter utilization has decreased due to a combination of Food and Drug Administration (FDA) advisory and legal effort, although the number of IVC filter placements remains high.[1] Along with the high filter placement, there has been a growing number of filter complications, including filter fracture, migration, tilting, and long-term complications such as postthrombotic syndrome.[2] [3] Among those, filter tilt often occurs during the immediate periprocedure timeframe and is associated with a decrease in filtering efficiency and an increase in retrieval difficulties. Many methods have been utilized to minimize filter tilt and one possible option is the use of the over-the-wire (OTW) technique, during which the OptionElite filter (Argon Medical Devices, Plano, TX) is deployed over a 0.035-inch guidewire. Similar to an OTW stent placement, the guidewire facilitates centering the filter within the IVC, thereby preventing filter tilt. Based on our experience, placing IVC filter in OTW fashion has certain unique benefits over the standard technique, specifically in cases of a tortuous IVC course. In this article, the technique of OTW IVC filter placement is described and depicted in detail along with a review of the technique in the context of the literature.
Publication History
Article published online:
03 June 2021
© 2021. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Ahmed O, Patel K, Patel MV. et al. Declining national annual IVC filter utilization: an analysis on the impact of societal and governmental communications. Chest 2017; 151 (06) 1402-1404
- 2 Li X, Partovi S, Gadani S, Martin C, Beck A, Vedantham S. Gastrointestinal malignancies and venous thromboembolic disease: clinical significance and endovascular interventions. Dig Dis Interv 2020; 04 (03) 260-266
- 3 Chapin W, Sudheendra P, Goity L, Sudheendra D. Epidemiology, prevention, diagnosis, and management of venous thromboembolism in gastrointestinal cancers. Dig Dis Interv 2020; 4 (03) 248-259
- 4 Zhu X, Tam MDBS, Bartholomew J, Newman JS, Sands MJ, Wang W. Retrievability and device-related complications of the G2 filter: a retrospective study of 139 filter retrievals. J Vasc Interv Radiol 2011; 22 (06) 806-812
- 5 Kim E, Brejt S, Reis S. et al. Abstract No. 653 A novel technique for transfemoral IVC filter placement to decrease tilting. J Vasc Interv Radiol 2018;
- 6 Deso SE, Idakoji IA, Kuo WT. Evidence-based evaluation of inferior vena cava filter complications based on filter type. Semin Intervent Radiol 2016; 33 (02) 93-100
- 7 Wittenberg G, Kueppers V, Tschammler A, Scheppach W, Kenn W, Hahn D. Long-term results of vena cava filters: experiences with the LGM and the Titanium Greenfield devices. Cardiovasc Intervent Radiol 1998; 21 (03) 225-229
- 8 Günther RW, Neuerburg J, Mossdorf A. et al. New optional IVC filter for percutaneous retrieval - in vitro evaluation of embolus capturing efficiency. Rofo 2005; 177 (05) 632-636
- 9 Singer MA, Wang SL. Modeling blood flow in a tilted inferior vena cava filter: does tilt adversely affect hemodynamics?. J Vasc Interv Radiol 2011; 22 (02) 229-235
- 10 Greenfield LJ, Proctor MC, Cho KJ, Wakefield TW. Limb asymmetry in titanium Greenfield filters: clinically significant?. J Vasc Surg 1997; 26 (05) 770-775
- 11 Rogers FB, Strindberg G, Shackford SR. et al. Five-year follow-up of prophylactic vena cava filters in high-risk trauma patients. Arch Surg 1998; 133 (04) 406-411 , discussion 412
- 12 Dinglasan LAV, Oh JC, Schmitt JE, Trerotola SO, Shlansky-Goldberg RD, Stavropoulos SW. Complicated inferior vena cava filter retrievals: associated factors identified at preretrieval CT. Radiology 2013; 266 (01) 347-354
- 13 Avgerinos ED, Bath J, Stevens J. et al. Technical and patient-related characteristics associated with challenging retrieval of inferior vena cava filters. Eur J Vasc Endovasc Surg 2013; 46 (03) 353-359
- 14 Li X, Haddadin I, McLennan G. et al. Inferior vena cava filter – comprehensive overview of current indications, techniques, complications and retrieval rates. Vasa 2020; 49 (06) 449-462
- 15 Sweeney TJ, Van Aman ME. Deployment problems with the titanium Greenfield filter. J Vasc Interv Radiol 1993; 4 (05) 691-694
- 16 Kinney TB, Rose SC, Weingarten KE, Valji K, Oglevie SB, Roberts AC. IVC filter tilt and asymmetry: comparison of the over-the-wire stainless-steel and titanium Greenfield IVC filters. J Vasc Interv Radiol 1997; 8 (06) 1029-1037
- 17 Johnson SP, Raiken DP, Grebe PJ, Diffin DC, Leyendecker JR. Single institution prospective evaluation of the over-the-wire Greenfield vena caval filter. J Vasc Interv Radiol 1998; 9 (05) 766-773
- 18 Schanzer H, Schanzer A. Guidewire entrapment during deployment of the over-the-guidewire stainless steel Greenfield filter: a device design-related complication. J Vasc Surg 2000; 31 (03) 607-610
- 19 Browne RJ, Estrada FP. Guidewire entrapment during Greenfield filter deployment. J Vasc Surg 1998; 27 (01) 174-176
- 20 Shelgikar C, Mohebali J, Sarfati MR, Mueller MT, Kinikini DV, Kraiss LW. A design modification to minimize tilting of an inferior vena cava filter does not deliver a clinical benefit. J Vasc Surg 2010; 52 (04) 920-924
- 21 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
- 22 Johnson MS, Nemcek Jr AA, Benenati JF. et al. The safety and effectiveness of the retrievable option inferior vena cava filter: a United States prospective multicenter clinical study. J Vasc Interv Radiol 2010; 21 (08) 1173-1184
- 23 Hull JE, Robertson SW. Bard Recovery filter: evaluation and management of vena cava limb perforation, fracture, and migration. J Vasc Interv Radiol 2009; 20 (01) 52-60
- 24 Hightower J, Alexander R, Lehrman E. et al. Complications of retrievable inferior vena cava filters: a retrospective comparison of Denali and option-ELITE filters. J Clin Interv Radiol ISVIR 2018; 2: 149-154
- 25 Park BG, Seo A, Lee SY. et al. Over-the-wire deployment techniques of option elite inferior vena cava filter: 3D printing vena cava phantom study. Eur J Radiol Open 2020; 7: 100227
- 26 Hastings GS, Chughtai S, Radack DM, Santilli JG. Repositioning the 12-F over-the-wire Greenfield filter. J Vasc Interv Radiol 2000; 11 (09) 1207-1210
- 27 Laroia ST, Guan JJ, Laroia AT, Lenhart L, Hayes AJ. A new catheter technique to correct severe IVC filter tilt during placement. J Clin Interv Radiol ISVIR 2020; 4 (01) 27-30