Techniques used for difficult retrievals of the Günther Tulip inferior vena cava filter: experience in 32 patients

J Vasc Interv Radiol. 2009 Jan;20(1):92-9. doi: 10.1016/j.jvir.2008.10.007. Epub 2008 Nov 21.


Purpose: To retrospectively review experience with difficult retrievals of Günther Tulip filters (GTFs) in which various techniques were used.

Materials and methods: From December 2004 to December 2006, 32 patients were referred to a single radiology department for GTF retrieval (25 women and seven men; mean age, 40 years; range, 21-60 y). All patients were evaluated, and 22 of these patients had undergone unsuccessful filter retrieval attempts elsewhere. In the remaining patients, significant tilt of the filter (n = 8) or difficult internal jugular vein access (n = 2) discouraged retrieval attempts. There were a total of 38 filters. Twenty-five patients had a filter in the infrarenal inferior vena cava (IVC). Among the remaining seven patients, six had bilateral iliac filters and one had a left iliac filter. Retrievals were performed via conventional technique-ie, by snaring the hook of the filter without additional maneuvers-or other techniques.

Results: Thirty-seven of 38 filters were successfully removed, for a success rate of 97%. Successful retrievals were performed with conventional (n = 4), catheter twist (n = 3), modified snare (n = 15), loop snare (n = 14), and balloon dilation (n = 1) techniques. The average dwell time for filters successfully removed was 58 days (range, 22-258 d). One failure occurred in a patient who had undergone unsuccessful retrieval previously. The hook of the filter and a displaced secondary strut, which had migrated superiorly, were incorporated into the IVC wall in this case.

Conclusions: Additional maneuvers were useful in these difficult retrievals of GTFs that might not otherwise be retrievable with the conventional method.

MeSH terms

  • Adult
  • Catheterization
  • Catheterization, Central Venous* / adverse effects
  • Device Removal / adverse effects
  • Device Removal / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Phlebography
  • Prosthesis Design
  • Radiography, Interventional*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Vena Cava Filters*
  • Vena Cava, Inferior / diagnostic imaging*
  • Young Adult