Skip to main navigation menu Skip to main content Skip to site footer

Review article: Biomedical intelligence

Vol. 144 No. 4546 (2014)

Late removal of retrievable caval filters

  • Ludwig von Segesser
  • Enrico Ferrari
  • Piergiorgio Tozzi
  • Saad Abdel-Sayed
  • Denis Berdajs
Cite this as:
Swiss Med Wkly. 2014;144:w14022


The advent of retrievable caval filters was a game changer in the sense, that the previously irreversible act of implanting a medical device into the main venous blood stream of the body requiring careful evaluation of the pros and cons prior to execution suddenly became a “reversible“ procedure where potential hazards in the late future of the patient lost most of their weight at the time of decision making. This review was designed to assess the rate of success with late retrieval of so called retrievable caval filters in order to get some indication about reasonable implant duration with respect to relatively “easy“ implant removal with conventional means, i.e., catheters, hooks and lassos. A PubMed search ( ) was performed with the search term „cava filter retrieval after 30 days clinical“, and 20 reports between 1994 and 2013 dealing with late retrieval of caval filters were identified, covering approximately 7,000 devices with 600 removed filters. The maximal duration of implant reported is 2,599 days and the maximal implant duration of removed filters is also 2,599 days. The maximal duration reported with standard retrieval techniques, i.e., catheter, hook and/or lasso, is 475 days, whereas for the retrievals after this period more sophisticated techniques including lasers, etc. were required. The maximal implant duration for series with 100% retrieval accounts for 84 days, which is equivalent to 12 weeks or almost 3 months. We conclude that retrievable caval filters often become permanent despite the initial decision of temporary use. However, such “forgotten“ retrievable devices can still be removed with a great chance of success up to three months after implantation. Conventional percutaneous removal techniques may be sufficient up to sixteen months after implantation whereas more sophisticated catheter techniques have been shown to be successful up to 83 months or more than seven years of implant duration. Tilting, migrating, or misplaced devices should be removed early on, and replaced if indicated with a device which is both, efficient and retrievable.


  1. Kaufman JA, MD, Kinney TB, MD, Streiff MB, MD, Sing RF, DO, Proctor MC, MS, Becker D, MD, MPH, et al. Guidelines for the Use of Retrievable and Convertible Vena Cava Filters: Report from the Society of Interventional Radiology Multidisciplinary Consensus Conference. J Vasc Interv Radiol. 2006;17:449–59
  2. Williams R, Schenk W. A removable intracaval filter for prevention of pulmonary embolism: early experience with the use of the Eichelter catheter in patients. Surgery. 1970;68:999–1008.
  3. Angel LF, Tapson V, Galgon RE, Restrepo MI, Kaufman J. Systematic review of the use of retrievable inferior vena cava filters. J Vasc Interv Radiol. 2011;22(11):1522–30.e3. doi: 10.1016/j.jvir.2011.08.024. Review.
  4. Kuo WT, Robertson SW, Odegaard JI, Hofmann LV. Complex retrieval of fractured, embedded, and penetrating inferior vena cava filters: a prospective study with histologic and electron microscopic analysis. J Vasc Interv Radiol. 2013;24(5):622–30.e1; quiz 631. doi: 10.1016/j.jvir.2013.01.008. Epub 2013 Mar 21.
  5. Smouse HB, Mendes R, Bosiers M, Van Ha TG, Crabtree T. The RETRIEVE trial: safety and effectiveness of the retrievable crux vena cava filter. RETRIEVE Investigators. J Vasc Interv Radiol. 2013;24(5):609–21. doi: 10.1016/j.jvir.2013.01.489.
  6. Kuo WT, Odegaard JI, Rosenberg JK, Hofmann LV. Excimer Laser-Assisted Removal of Embedded Inferior Vena Cava Filters: A Single-Center Prospective Study. Circ Cardiovasc Interv. 2013;24. [Epub ahead of print]
  7. Van Ha TG, Dillon P, Funaki B, Zangan S, Lorenz J, Piano G, et al. Use of retrievable filters in alternative common iliac vein location in high-risk surgical patients. J Vasc Interv Radiol. 2011;22(3):325–9. doi: 10.1016/j.jvir.2010.09.033. Epub 2011 Feb 1.
  8. Angel LF, Tapson V, Galgon RE, Restrepo MI, Kaufman J. Systematic review of the use of retrievable inferior vena cava filters. J Vasc Interv Radiol. 2011;22(11):1522–30.e3. doi: 10.1016/j.jvir.2011.08.024.
  9. Johnson MS, Nemcek AA Jr, Benenati JF, Baumann DS, Dolmatch BL, Kaufman JA, et al. The safety and effectiveness of the retrievable option inferior vena cava filter: a United States prospective multicenter clinical study. J Vasc Interv Radiol. 2010;21(8):1173–84. doi: 10.1016/j.jvir.2010.04.004. Epub 2010 Jul 3.
  10. Binkert CA, Drooz AT, Caridi JG, Sands MJ, Bjarnason H, Lynch FC, et al. Technical success and safety of retrieval of the G2 filter in a prospective, multicenter study. J Vasc Interv Radiol. 2009;20(11):1449–53. doi:10.1016/j.jvir.2009.08.007.
  11. Sangwaiya MJ, Marentis TC, Walker TG, Stecker M, Wicky ST, Kalva SP. Safety and effectiveness of the celect inferior vena cava filter: preliminary results. J Vasc Interv Radiol. 2009;20(9):1188–92. doi: 10.1016/j.jvir.2009.05.033. Epub 2009 Jul 23.
  12. Yamagami T, Kato T, Hirota T, Yoshimatsu R, Matsumoto T, Nishimura T. Evaluation of retrievability of the Gunther tulip vena cava filter. Cardiovasc Intervent Radiol. 2007;30(2):226–31.
  13. Piano G, Ketteler ER, Prachand V, Devalk E, Van Ha TG, Gewertz BL, et al. Safety, feasibility, and outcome of retrievable vena cava filters in high-risk surgical patients. J Vasc Surg. 2007;45(4):784–8; discussion 788.
  14. Bovyn G, Ricco JB, Reynaud P, Le Blanche AF. Long-duration temporary vena cava filter: a prospective 104–case multicenter study. European Tempofilter II Study Group. J Vasc Surg. 2006;43(6):1222–9.
  15. Stefanidis D, Paton BL, Jacobs DG, Taylor DA, Kercher KW, Heniford BT, et al. Extended interval for retrieval of vena cava filters is safe and may maximize protection against pulmonary embolism. Am J Surg. 2006;192(6):789–94.
  16. De Gregorio MA, Gamboa P, Bonilla DL, Sanchez M, Higuera MT, Medrano J, et al. Retrieval of Gunther Tulip optional vena cava filters 30 days after implantation: a prospective clinical study. J Vasc Interv Radiol. 2006;17(11 Pt 1):1781–9.
  17. Rosenthal D, Swischuk JL, Cohen SA, Wellons ED. OptEase retrievable inferior vena cava filter: initial multicenter experience. Vascular. 2005;13(5):286–9.
  18. Imberti D, Bianchi M, Farina A, Siragusa S, Silingardi M, Ageno W. Clinical experience with retrievable vena cava filters: results of a prospective observational multicenter study. J Thromb Haemost. 2005;3(7):1370–5.
  19. Nakagawa N, Cragg AH, Smith TP, Castaneda F, Barnhart WH, DeJong SC. A retrievable nitinol vena cava filter: experimental and initial clinical results. J Vasc Interv Radiol. 1994;5(3):507–12.
  20. Lee L, Taylor J, Munneke G, Morgan R, Belli AM. Radiology-led follow-up system for IVC filters: effects on retrieval rates and times. Cardiovasc Intervent Radiol. 2012;35(2):309–15. doi: 10.1007/s00270–011–0198–7. Epub 2011 Jun 4.
  21. Imai H, Schaap RN, Mortensen JD. Rate of thrombus accumulation on intravenacaval IVOX devices explanted from human clinical trial patients with acute respiratory failure. Artif Organs. 1994;18(11):818–21.
  22. von Segesser LK, Schaffner A, Stocker R, Lachat M, Speich R, Baumann PC, et al. Extended (29 days) use of intravascular gas exchanger. Lancet. 1992;339(8808):1536.
  23. Li L, Abdel-Sayed S, Berdajs D, Tozzi P, von Segesser LK, Ferrari E. Caval collapse during cardiopulmonary bypass: a reproducible bench model. Eur J Cardiothorac Surg. 2014;46(2):306-12.
  24. Berdajs D, Born F, Crosset M, Horisberger J, Künzli A, Ferrari E, et al. Superior venous drainage in the "LifeBox": a portable extracorporeal oxygenator with a self-expanding venous cannula. Perfusion. 2010;25(4):211–5. doi: 10.1177/0267659110375863.
  25. Straub A, Schnur W, Rehn E-C, Quinz H, Oertel F, Beyer M. Erfahrungen mit der Smart Canula® zur venosen Drainage im Langzeiteinsatz. Kardiotechnik. 2011;4:111–3.
  26. Vorwerk D, Redha F, Neuerburg J, Clerc C, Günther RW. Neointima formation following arterial placement of self-expanding stents of different radial force: experimental results. Cardiovasc Intervent Radiol. 1994;17(1):27–32.

Most read articles by the same author(s)

1 2 > >>