Paul J. Foley, MD, Derek P. Nathan, MD, Grace J. Wang, MD, Edward Y

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Presentation transcript:

A “fall-back” technique for difficult inferior vena cava filter retrieval Paul J. Foley, MD, Derek P. Nathan, MD, Grace J. Wang, MD, Edward Y. Woo, MD, S. William Stavropoulos, MD, Richard D. Shlansky- Goldberg, MD, Ronald M. Fairman, MD, Benjamin M. Jackson, MD Journal of Vascular Surgery Volume 56, Issue 6, Pages 1629-1633 (December 2012) DOI: 10.1016/j.jvs.2012.02.063 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Fall-back technique. A, An 18F sheath is advanced to the level of the filter hook. B, The Bentson wire and snare are maneuvered through separate filter interstices. The wire is snared below the filter legs and secured. C, The resulting lasso is pulled up below the filter collar. D, The 18F sheath is advanced over the filter. E, The filter is collapsed into the sheath and removed. Journal of Vascular Surgery 2012 56, 1629-1633DOI: (10.1016/j.jvs.2012.02.063) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 A, The tip of the 11F sheath often follows the path of the lasso below the filter collar and is not large enough to advance over the hook. B, An 18F sheath has a larger tip diameter to be able to advance over the hook when used with the fall-back technique. Journal of Vascular Surgery 2012 56, 1629-1633DOI: (10.1016/j.jvs.2012.02.063) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 A, An 11F sheath with the conventional snare technique did not provide enough columnar strength to fully collapse the filter inside the sheath. Note the deformed sheath tip. B, Collapse of the 11F sheath from repeated attempts to retrieve the filter. The filter was successfully removed using an 18F sheath. Journal of Vascular Surgery 2012 56, 1629-1633DOI: (10.1016/j.jvs.2012.02.063) Copyright © 2012 Society for Vascular Surgery Terms and Conditions