الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Anticoagulation is the usual treatment for deep vein thrombosis (DVT); however, due to contraindications to anticoagulation or recurrent thromboembolism despite therapeutic anticoagulation, a growing number of patients need alternative treatment, which involves the insertion of an inferior vena cava (IVC) filter. The utilization of inferior vena cava (IVC) filters has witnessed a continuous upward trend. This surge can be attributed to several factors, including the growing availability of retrievable filters, the facilitation and widespread adoption of percutaneous placement techniques, and the broadening of clinical indications to include poor patient adherence to anticoagulation regimens, prophylactic placement in trauma or bariatric surgery settings, and advanced malignancy. As practice patterns change the threshold for filter insertion is lowered, and the rates of IVC filter removal stay incredibly low Even though the majority of retrievable filters are set with the intention of being removed. As a result, a large number of retrievable IVC filters have turned into permanent devices with long dwell periods. The risk of possible complications such as filter migration, IVC thrombosis, filter penetration, and fracture increases with longer dwell durations for IVC filters. In light of these potential complications, the timely removal of retrievable IVC filters becomes a matter of significant clinical interest.
Therefore, the present study has been designed to study the efficacy and technical feasibility of IVC filter retrieval procedure as well as the complications of such procedure.
The current study was carried out in Alexandria Main University Hospital on 20 patients planned for elective IVC filter retrieval with mean age of 33.05 ± 10.14 years. Patients with permanent filters, patients with IVC occlusion and patients that had no access route to the IVC have been excluded from this study.
All cases were assessed preoperatively by proper history taking, complete physical examination, Xray, duplex and CT scan. They then underwent the procedure to attempt retrieval of the IVC filter. The technique typically utilizes a single venous access point and a 12 Fr sheath is then introduced towards the filter. A snare is then used to engage the filter’s hook and the sheath is advanced to collapse the filter, allowing for removal through the sheath. IVC venogram is performed before and After the retrieval to exclude residual thrombus in filter and to verify the integrity of the IVC. The system is then removed and manual compression is held for 10 minutes. Different parameters were assessed as dwelling time & shape of the IVC filter, type of anaesthesia, success or failure of retrieval, fluoroscopy time and different complications that occurred during the procedure.
This study demonstrates that endovascular techniques for retrieval of IVC filters are effective, technically feasible and safe in the removal of IVC filters. Rate of successful retrieval was 90%. Rate of significant complications was 5%. Mean fluoroscopy time was 25.0 ± 12.34 minutes. Frequent employment of advanced techniques is necessary for complex retrievals. Indeed, prolonged dwell times for IVC filters is associated with technical difficulties due to filter tilt and endothelialization as well as increased complication rate.