Is a Venocavagram Necessary after Inferior Vena Cava Filter Retrieval?

This single-institution, 10-year retrospective cohort study involved all 245 patients with successful IVC filter retrieval and having a postretrieval venacavogram. Excluding 22 patients for missing records (four for extensive baseline thrombosis and two due to retrieval within a day) left 228 retrievals (120 routine and 108 complex) in 224 patients (four patients required two filter retrievals). The majority of filters were the Recovery series, Celect, or Gunther Tulip designs. A prior retrieval was attempted in one routine and 73 complex retrieval cases. A complex retrieval was defined as one requiring forceps or other adjuncts beyond a snare or dedicated retrieval device. The only major abnormality after retrieval was extravasation (three cases and only in the complex group). The treatment in each was balloon tamponade to approximate IVC diameter for 5-minute inflations repeated until resolution and then observation. There were more minor abnormalities noted after complex retrievals (n = 85) than routine retrievals (n = 62; P < .001). Minor abnormalities (consisting of stenosis, the most significant being the 51%-75% category) were noted in 2% vs 6% routine vs complex cases, and spasm and filling defects (not clearly defined but noted as present in 10% routine vs 38% complex cases; P = .001) had no effect on patient management. The frequency of abnormalities did not vary with filter type nor dwell time. There was no clinical follow-up of these patients.