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Surgical and Interventional Considerations in the Retrieval of the CelectTM Inferior Vena Cava Filters

Although inferior vena cava filters (IVCFs) are a known method for caval interruption
and prevention of pulmonary embolism (PE), there is a lack of controlled trials
conclusively proving that IVCF placement actually reduces the risk of PE or
death. Additionally, their use has become a far more common practice since the
development of retrievable IVCFs. The rationale for the use of retrievable IVCFs
is that they provide the theoretical benefit of protection from PE, while allowing
their removal when they are no longer needed, thus resulting in fewer long-term
complications. Unfortunately, it is a fact that the majority of retrievable IVCFs are
not removed and that they are associated with significant complications, most
notably vena cava perforation and thrombosis. The Celect retrievable IVCF (Cook
Medical, Bloomington, IN) is one of the systems available in the United States for
caval interruption.
This manuscript describes three challenging cases of retrieval of Celect IVCFs. The
first is the case of a young female who developed late complications related to a
retrievable Celect IVCF that caused infrarenal caval occlusion and perforation into
the surrounding retroperitoneal structures. She ultimately required open surgical
filter retrieval. In addition, we also describe two patients in which alternative
percutaneous methods for IVCF retrieval were used. We briefly review the
literature concerning indications for IVCF placement and some of the pitfalls that
can be encountered while attempting their retrieval. Further studies are necessary
to investigate the efficacy and outcomes of retrievable IVCFs.


Luis R Leon Jr., Franchell Vazquez, Eduardo Espinoza, John P Pacanowski Jr. and John D Hughes

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