Inferior Vena Cava Filter Retrieval
This section provides a comprehensive procedural report for inferior vena cava filter retrieval procedure with up-to-date explanatory notes, synopsis of the indications and contraindications and potential complications in an organized and practical format
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Abbreviations
VTE
Venous thromboembolism
INTRODUCTION Retrievable filters may be placed with the intent of either temporary or permanent filtration. These filters are designed to allow percutaneous filter removal or repositioning during a device-specific window of retrievability. Placement of a retrievable filter with the intent to discontinue filtration follows the same indications used for permanent vena cava filters. The decision to use these filters therefore is based on the anticipated required duration of protection against clinically significant venous thromboembolism (VTE) and/ or risk of pharmacologic VTE therapy or prophylaxis. Discontinuation of caval filtration is generally recommended when the indication for the caval interruption is no longer present and is not anticipated to recur or when the risk of recurrent VTE is estimated to be less than the risk of leaving the filter in place.
COMMON INDICATIONS [1–3] Absolute Indications: the filter is a source of major complication: • Filter migration • Malpositioned filter • Intracardiac migration of the filter • Symptomatic penetration of the wall of vena cava by filter limbs • Filter dysfunction due to change in position or structural damage Relative Indications: • Effective pharmacological VTE therapy or prophylaxis is achieved • Resolution of risk factors for VTE • Discontinuation of filtration to avoid lifelong anticoagulation after resolution of VTE and its risk factors
COMMON CONTRAINDICATIONS [2, 3]
B. Taslakian (&) Department of Radiology, New York University Langone Medical Center, New York, NY, USA e-mail: [email protected]
• Delayed removal exceeding the specified temporal window of retrievability • Persistent indication for vena caval filtration • Large retained thrombus within the filter
© Springer International Publishing Switzerland 2016 B. Taslakian et al. (eds.), Procedural Dictations in Image-Guided Intervention, DOI 10.1007/978-3-319-40845-3_82
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• Failure to achieve adequate pharmacological VTE therapy or prophylaxis • Noncompliant patients with the pharmacological therapy or follow-up appointments • High-risk state for recurrent VTE • Short (i.e.,
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