Factors Associated with Failed Retrieval of the Günther Tulip Inferior Vena Cava Filter

• Published in: Journal of vascular and interventional radiology Vol. 19; no. 9; pp. 1321 - 1327
• Main Authors: Marquess, Joel S., BS, Burke, Charles T., MD, Beecham, Ashley H., MS, Dixon, Robert G., MD, Stavas, Joseph M., MD, Sag, Alan A., BS, Koch, Gary G., PhD, Mauro, Matthew A., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2008
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Device Removal - statistics & numerical data; Female; Humans; Incidence; Longitudinal Studies; Male; Middle Aged; Radiology; Retrospective Studies; Risk Assessment - methods; Risk Factors; Treatment Failure; Vena Cava Filters - statistics & numerical data; Venous Thrombosis - epidemiology; Venous Thrombosis - surgery; GTF; inferior vena cava; PE; pulmonary emboli; Günther Tulip filter; IVC
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2008.06.004

Purpose To identify potential factors associated with failed retrieval of the Günther Tulip inferior vena cava (IVC) filter. Materials and Methods A retrospective review was performed of patients who underwent placement of the Günther Tulip filter with at least one attempt at filter retrieval over a 3-year period. Patient demographics, filter dwell time, filter angulation, and filter leg protrusion were analyzed. Results A total of 188 patients were included in the study. Primary retrieval success was achieved in 166 patients (88.3%), for an overall retrieval success rate of 94.2%. The overall mean dwell time was 63 days, whereas the mean dwell time in cases of retrieval failure was 95.4 days. A total of seven filters were in place for longer than 6 months, four of which were successfully retrieved. The degree of filter tilt was not found to be significantly related to retrieval success ( P = .36), even though filter angulation was commonly cited as a reason for retrieval failure. On venography, 90.9% of filters that could not be retrieved showed leg protrusion beyond the lumen of the IVC. Finally, increasing patient age also correlated with retrieval failure ( P = .01). Conclusions Prolonged dwell time and increasing patient age are associated with failed filter retrieval. However, even filters in place for extended periods can be safely removed.