Perforation of the IVC: Rule Rather Than Exception After Longer Indwelling Times for the Gu¨nther Tulip and Celect Retrievable Filters
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Jeremy C. Durack Antonio C. Westphalen Stephanie Kekulawela Shiv B. Bhanu David E. Avrin Roy L. Gordon Robert K. Kerlan
- چاپ و سال / کشور: 2011
Description
Purpose This study was designed to assess the incidence, magnitude, and impact upon retrievability of vena caval perforation by Gu¨nther Tulip and Celect conical inferior vena cava (IVC) filters on computed tomographic (CT) imaging. Methods Gu¨nther Tulip and Celect IVC filters placed between July 2007 and May 2009 were identified from medical records. Of 272 IVC filters placed, 50 (23 Gu¨nther Tulip, 46%; 27 Celect, 54%) were retrospectively assessed on follow-up abdominal CT scans performed for reasons unrelated to the filter. Computed tomography scans were examined for evidence of filter perforation through the vena caval wall, tilt, or pericaval tissue injury. Procedure records were reviewed to determine whether IVC filter retrieval was attempted and successful. Results Perforation of at least one filter component through the IVC was observed in 43 of 50 (86%) filters on CT scans obtained between 1 and 880 days after filter placement. All filters imaged after 71 days showed some degree of vena caval perforation, often as a progressive process. Filter tilt was seen in 20 of 50 (40%) filters, and all tilted filters also demonstrated vena caval perforation. Transjugular removal was attempted in 12 of 50 (24%) filters and was successful in 11 of 12 (92%). Conclusions Longer indwelling times usually result in vena caval perforation by retrievable Gu¨nther Tulip and Celect IVC filters. Although infrequently reported in the literature, clinical sequelae from IVC filter components breaching the vena cava can be significant. We advocate filter retrieval as early as clinically indicated and increased attention to the appearance of IVC filters on all follow-up imaging studies.
Cardiovasc Intervent Radiol DOI 10.1007/s00270-011-0151-9 Received: 22 December 2010 / Accepted: 11 March 2011
