Journal List > J Korean Surg Soc > v.79(6) > 1011210

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No, Kim, Kim, Kim, Shin, Ahn, Cho, Kim, Lee, Hur, Choi, Choe, Jeon, Cho, and Hong: Inferior Vena Cava (IVC) Filter Retrieval Rates after Catheter Directed Thrombolysis or Pharmacomechanical Thrombectomy in Deep Vein Thrombosis (DVT) and Its Characteristics
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2010; 79(6): 497-502.

Published online: 31 December 2010

DOI: https://doi.org/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

Hyo Keun No, M.D., Joong Suck Kim, M.D., Jang Yong Kim, M.D., Kyung Rae Kim, M.D., Seok-Hwan Shin, M.D., Seung-Ik Ahn, M.D., Young Up Cho, M.D., Sei Joong Kim, M.D., Keon-Young Lee, M.D., Yoon-Seok Hur, M.D., Sun Keun Choi, M.D., Yun-Mee Choe, M.D., Yong Sun Jeon, M.D.1, Soon Gu Cho, M.D.1, Kee Chun Hong, M.D.

Department of Surgery, Inha University School of Medicine, Incheon, Korea.

1Department of Radiology, Inha University School of Medicine, Incheon, Korea.

Corresponding author (inhags@gmail.com)

Received 28 April 2010       Accepted 21 July 2010

Copyright © 2010 The Korean Surgical Society

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.

Keywords: Inferior vena cava filter, Deep vein thrombosis, Thrombolysis

Figures and Tables

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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Table 1
Patient characteristics (n=126)
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*IVC = inferior vena cava; †DVT = deep vein thrombosis.

Table 2
Main complications reported with use of inferior vena cava filters
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*IVC = inferior vena cava.

Table 3
Comparison of retrievable filters available in Korea
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Table 4
Results of IVC filter retrieval after conventional use of IVC filter
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