Rigid forceps and excimer laser use for complex inferior cava filter retrieval: a preliminary quantitative analysis of available evidence

Authors

Qian Yu, Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois, 60637, USA. qian.yu@uchospitals.edu.
Patrick Tran, Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois, 60637, USA.
Deepak Iyer, School of Medicine, George Washington University, Washington D.C., 20052, USA.
Subhash Gutti, School of Medicine, George Washington University, Washington D.C., 20052, USA.
Davey Li, College of Medicine, University of Illinois at Chicago, Chicago, IL, 60612, USA.
Xin Li, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA.
Rakesh Navuluri, Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois, 60637, USA.
Thong Van Ha, Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois, 60637, USA.
Osman Ahmed, Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois, 60637, USA.

Document Type

Journal Article

Publication Date

7-8-2022

Journal

CVIR endovascular

Volume

5

Issue

1

DOI

10.1186/s42155-022-00311-4

Keywords

Filter retrieval; Forceps; Inferior vena cava filter; Laser

Abstract

PURPOSE: The present study aims to evaluate the safety and efficacy of advanced inferior vena cava filter (IVCF) retrieval using laser assistance compared with forceps via systematic review and quantitative aggregation of available data. METHODS: Pubmed and Embase were queried from establishment to September 2021. Original studies with a sample size ≥ 5 that reported at least one primary outcome of patients who underwent laser- or forceps-assisted IVCF retrieval were included. Primary outcomes included technical success and complication rates. Baseline characteristics were extracted: age, sex, presence of filter thrombus, strut penetration, previous retrieval attempt, filter dwell time, fluoroscopy time, and filter type. Complications were categorized by type and severity. Categorical data was pooled and evaluated with chi-square or Fisher exact tests. RESULTS: From the 16 included studies, a total of 673 and 368 patients underwent laser- and forceps-assisted IVCF retrieval, respectively. Successful retrieval was achieved in 98.1 and 93.7% patients from the laser and forceps groups, respectively (p < 0.001). Major complication rates (1.6 vs 2.1%, p = 0.629) and risk of injury to cava or adjacent organs (1.0 vs 1.4%, p = 0.534) were similar between the two groups. A higher proportion of filters from the laser arm were closed-cell design (75.4 vs 68.1%, p = 0.020). CONCLUSION: Based on limited available evidence, forceps- and laser-assisted complex IVCF retrievals were equally safe. The use of laser sheath is associated with a higher retrieval rate than forceps alone, though the baseline characteristics of two cohorts were not controlled. Future large-scale case-controlled comparative studies with longer clinical follow-up are warranted.

APA Citation

Yu, Qian; Tran, Patrick; Iyer, Deepak; Gutti, Subhash; Li, Davey; Li, Xin; Navuluri, Rakesh; Van Ha, Thong; and Ahmed, Osman, "Rigid forceps and excimer laser use for complex inferior cava filter retrieval: a preliminary quantitative analysis of available evidence" (2022). GW Authored Works. Paper 1339.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1339

Department

School of Medicine and Health Sciences Student Works