SIR 2024
Venous Interventions
Brittany Brookner, BA (she/her/hers)
Medical Student
Georgetown University School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Neil K. Jain, DO (he/him/his)
Integrated Interventional Radiology Resident
Medstar Georgetown University Hospital
Financial relationships: Full list of relationships is listed on the CME information page.
Delisia Wicks, BA, MS
Medical Student
Georgetown University School of Medicine
Disclosure information not submitted.
Charles Scott Dorris, BA
Associate Director of Research Services
Georgetown University
Disclosure information not submitted.
John B. Smirniotopoulos, MD
Assistant Professor of Radiology
MedStar Georgetown University Hospital
Financial relationships: Full list of relationships is listed on the CME information page.
33 papers consisting of 1410 subjects were included in the analysis comparing the six most utilized advanced retrieval methods: balloon displacement, excimer laser, forceps, hangman, loop snare, and snare over guidewire loop (SOGL). Meta-analysis revealed pooled rates for successful retrievals and complications as 93% (95% CI: 90% - 97%) and 4% (95% CI: 2% - 5%), respectively. There was statistically significant between-study heterogeneity for successful retrieval rates (p < 0.0001), while the between-study heterogeneity for complication rates was not statistically significant. Amongst method types, balloon displacement had a success rate of 57.7%, which is significantly poorer compared to forceps, hangman, loop snare, excimer laser technique, and SOGL (p = 0.006, p = 0.015 for SOGL, respectively). The complication rates amongst method types were comparable except when stratifying for minor complications; the minor complication rate for forceps was 3.5% higher than that of excimer laser (p = 0.0053).
Conclusion:
Systematic review of advanced IVC-F retrieval techniques have demonstrated to be safe and efficacious. Among the advanced techniques, balloon displacement was the least effective advanced method for filter removal while maintaining a similar complication rate as the other advanced techniques.