Jorge E Lopera1, Laura Barnes1. 1. Department of Radiology, University of Texas at San Antonio, San Antonio, Texas.
Abstract
PURPOSE: To report a 10-year clinical experience with superior vena cava (SVC) retrievable filters. METHODS: A retrospective review of patients with SVC filters was performed between 2008 and 2018 in a single tertiary medical center. Patient demographics, indications for filter placement, type of filter placed, and clinical evolution were recorded. Complications during placement, retrieval, and follow-up were determined. RESULTS: Fifty patients ages 17-89 years (average 54) underwent SVC retrievable filter placement. Main indication for filter placement was deep venous thrombosis of the major upper extremity and/or internal jugular veins with contraindications to anticoagulation. Complications during placement included inadvertent filter placement in the right brachiocephalic vein in two patients, another patient had a leg of the filter entrapped in the tip of a hemodialysis catheter that required filter reposition and line exchange. Thirteen patients had attempted retrieval with 12 filters successfully removed 7-420 days after placement (mean 170). On follow-up images available in 24 patients, 13 filters were noted to be significantly tilted and 10 filters had evidence of leg penetration. No other serious late complications were noted. CONCLUSION: The use of retrievable SVC filters in patients with upper extremity DVT is highly questionable. There is a high incidence of filter malposition, filter tilting, and leg penetration.
PURPOSE: To report a 10-year clinical experience with superior vena cava (SVC) retrievable filters. METHODS: A retrospective review of patients with SVC filters was performed between 2008 and 2018 in a single tertiary medical center. Patient demographics, indications for filter placement, type of filter placed, and clinical evolution were recorded. Complications during placement, retrieval, and follow-up were determined. RESULTS: Fifty patients ages 17-89 years (average 54) underwent SVC retrievable filter placement. Main indication for filter placement was deep venous thrombosis of the major upper extremity and/or internal jugular veins with contraindications to anticoagulation. Complications during placement included inadvertent filter placement in the right brachiocephalic vein in two patients, another patient had a leg of the filter entrapped in the tip of a hemodialysis catheter that required filter reposition and line exchange. Thirteen patients had attempted retrieval with 12 filters successfully removed 7-420 days after placement (mean 170). On follow-up images available in 24 patients, 13 filters were noted to be significantly tilted and 10 filters had evidence of leg penetration. No other serious late complications were noted. CONCLUSION: The use of retrievable SVC filters in patients with upper extremity DVT is highly questionable. There is a high incidence of filter malposition, filter tilting, and leg penetration.
Authors: Miguel A De Gregorio; Jose A Guirola; Sergio Sierre; Jose Urbano; Juan Jose Ciampi-Dopazo; Jose M Abadal; Juan Pulido; Eduardo Eyheremendy; Elena Lonjedo; Guadalupe Guerrero; Carolina Serrano-Casorran; Pedro Pardo; Micaela Arrieta; Jose Rodriguez-Gomez; Cristina Bonastre; George Behrens; Carlos Lanciego; Hector Ferral; Mariano Magallanes; Santiago Mendez; Mercedes Perez; Jimena Gonzalez-Nieto; William T Kuo; David Jimenez Journal: J Clin Med Date: 2021-12-24 Impact factor: 4.241