J Korean Surg Soc.  2010 Dec;79(6):497-502. 10.4174/jkss.2010.79.6.497.

Inferior Vena Cava (IVC) Filter Retrieval Rates after Catheter Directed Thrombolysis or Pharmacomechanical Thrombectomy in Deep Vein Thrombosis (DVT) and Its Characteristics

• No HK
• Kim JS
• Kim JY
• Kim KR
• Shin SH
• Ahn SI
• Cho YU
• Kim SJ
• Lee KY
• Hur YS
• Choi SK
• Choe YM
• Jeon YS
• Cho SG
• Hong KC

• KMID: 2096608
• DOI: http://doi.org/10.4174/jkss.2010.79.6.497

Abstract

PURPOSE
Inferior vena cava (IVC) filter is commonly practiced to prevent pulmonary embolism during endovascular therapy of deep vein thrombosis (EndoDVT). When the thrombus is trapped inside the filter during intervention, its removal is quite challenging. The purpose of this study is to determine retrieval rates of IVC filter after EndoDVT and its characteristics.
METHODS
Patients who underwent EndoDVT in Inha Unversity Hospital from June 2004 to May 2009 were reviewed retrospectively. Retrievable IVC filter was inserted before EndoDVT. EndoDVT was done by catheter directed thrombolysis or pharmacomechanical thrombectomy using urokinase. IVC filter retrieval was decided according to computed tomography after 2 weeks.
RESULTS
126 patients were treated with EndoDVT. Optease (n=101) and Tulip (n=25) IVC filters were inserted. IVC filters were retrieved in 42.9% (54/126). There was no IVC filter related complication during its insertion and removal. IVC filter was not retrieved in 72 patients. Reasons for its failure include residual thrombosis in IVC filter (n=28), high risk for recurrent DVT (n=34), massive pulmonary embolism (n=8), and death (n=2). Residual thrombus inside IVC filter disappeared in 5 patients during 6-month follow up.
CONCLUSION
IVC filters retrieval rate after EndoDVT was 42.9%. This can be improved by thorough patient follow up and extended retrievability.

Keyword

Inferior vena cava filter; Deep vein thrombosis; Thrombolysis

MeSH Terms

Catheters
Follow-Up Studies
Humans
Pulmonary Embolism
Retrospective Studies
Thrombectomy
Thrombosis
Tulipa
Urokinase-Type Plasminogen Activator
Vena Cava Filters
Vena Cava, Inferior
Venous Thrombosis
Urokinase-Type Plasminogen Activator

Figure

• 

  Fig. 1 CT images of 47-year-old male suffering from acute deep vein thrombosis with pulmonary embolism. (A) Thrombus was trapped inside Optease IVC filter (2 weeks after insertion). (B) Thrombus disappeared inside Optease IVC filter (6 months after insertion).

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