Long-term Retrieval Success Rate Profile for the Günther Tulip Vena Cava Filter
Received 12 March 2008; received in revised form 6 February 2009; accepted 9 March 2009. published online 28 May 2009.
Purpose
To evaluate the likelihood of successful retrieval of the Günther Tulip vena cava filter after various implant durations (up to 494 days).
Materials and Methods
Retrievable Günther Tulip filters were placed in 554 patients. All patients satisfied requirements for filter placement; the primary indication for placement was specified for 394 patients (71%), as follows: unspecified trauma (n = 164), bariatric procedures (n = 128), orthopedic procedures (n = 36), and other (n = 66). Filter tilt and vena cava injury were assessed at implantation. Filters were not repositioned after placement. At retrieval, filter orientation, vena cava injury, other device-related incidents, and the degree of difficulty associated with retrieval were reported.
Results
Filter retrieval was attempted in 275 patients and successful in 248 (90.2%). The mean filter indwell time was 58.9 days (range, 3–494 days). Unsuccessful retrievals (n = 27) were attributed primarily to improper hook orientation (n = 10) or excessive tissue in-growth at the filter legs (n = 16). Of the remaining 279 patients, 223 withdrew from the study, 41 were associated with a decision to keep the filter as a permanent device, 13 died for reasons unrelated to the study, and two had no reported endpoint data. A Kaplan-Meier product-limit survival estimate revealed that the probability of successful device retrieval remained greater than 94% at 12 weeks and greater than 67% at 26 weeks.
Conclusions
This study contributes to the body of clinical data related to retrievable filters, demonstrating reliable retrieval rates at 12 weeks, with successful retrievals up to 17 months after implantation.
aDepartment of Vascular and Interventional Radiology, OSF St. Francis Medical Center, Peoria, Illinois
bDepartment of Vascular and Interventional Radiology, Atlanta Medical Center, Atlanta, Georgia
cDepartment of Vascular Surgery, University of Chicago, Chicago, Illinois
dDepartment of Vascular and Interventional Radiology, Spectrum Health, Grand Rapids, Michigan
eDepartment of Vascular and Interventional Radiology, University of North Carolina, Chapel Hill, North Carolina
fMED Institute, 1 Geddes Way, West Lafayette, IN 47906
Address correspondence to J.A.M.B.
None of the authors have identified a conflict of interest.
H.B.S. serves as a paid consultant to Cook Incorporated. W.D.V. is an employee of MED Institute, a Cook Group company. He is a salaried employee of the company. J.A.M.B. is an employee of MED Institute, a Cook Group company. She is a salaried employee of the company.
An interim report was presented at the 2007 annual meeting.
ABSTRACT
Long-term Retrieval Success Rate Profile for the Günther Tulip Vena Cava Filter