Outcomes and Challenges in Inferior Vena Cava Filter Retrieval: A Retrospective Analysis of Routine and Complex Cases

Abstract

Objectives: Inferior vena cava (IVC) filters play a vital role in preventing pulmonary embolism (PE) in patients who cannot undergo anticoagulation therapy. While retrievable filters offer temporary protection, their removal can become increasingly challenging, particularly in cases with prolonged dwell times, filter embedment, tilt, or migration. This study aimed to evaluate the outcomes of IVC filter retrieval procedures at our institution, focusing on factors influencing technical success and procedural complexity. Methodology: We conducted a retrospective observational study involving 31 patients who underwent attempted IVC filter retrieval. Collected data included patient demographics, filter characteristics (type and placement site), retrieval approaches (simple vs. complex), procedural durations, and outcomes. Simple retrievals were defined as those completed using standard snare techniques, whereas complex retrievals required advanced methods due to technical challenges such as filter embedment or tilt. Results: The overall technical success rate was 87.1% (27/31). Simple retrievals (n = 21) were all successful (100%), while complex retrievals (n = 10) achieved a success rate of 70% (7/10). Mean procedure time for simple retrievals was 25.5 minutes (range: 15–34 minutes), significantly shorter than that of complex retrievals, which averaged 48.2 minutes (range: 39–84 minutes) (p = 0.001). Conclusion: Our findings underscore the importance of timely IVC filter retrieval. Complex retrievals—often associated with longer dwell times and anatomical complications—require advanced techniques and are associated with increased procedure time and reduced success. Establishing structured follow-up systems and specialized retrieval protocols is essential for improving outcomes in patients with indwelling IVC filters.