Gerard Goh, Radiology, The Alfred Hospital, Melbourne, Australia, reported results from a comparative study of inferior vena cava (IVC) filters at CIRSE 2017 that examined the effectiveness, safety and complication rates of the Celect, Celect Platinum and ALN vena cava filters.
While all three inferior vena cava filters, Celect, Celect Platinum (both from Cook Medical) and ALN vena cava filter (ALN), demonstrated safety and high rates of retrievability, the incidence of minor complications was quite high, with limb penetration being the most common.
“As far as the authors are aware this is the first data on the Celect Platinum filter. The study was a retrospective review of hospital medical records of patients receiving an inferior vena cava filter in a level one trauma centre and was performed between November 2011 and June 2016,” Goh said.
Two interventional radiologists examined each filter episode with available angiography and CT images. They also examined the patients’ medical notes for each admission and to extract the relevant data.
Results
Goh and colleagues reported that 476 filters were placed (161 ALN; 153 Celect; and 162 Celect Platinum). Of the filters with follow-up imaging, limb penetration was the highest minor complication recorded at just under 65% for ALN and Celect, while it was nearer 35% for Celect Platinum. Malposition (including tilt >15 degrees), was the next most frequent complication with 22% of ALN filters moving out of position followed by 8% of Celect filters and 4% of Celect Platinum filters.
Of the patients with follow up imaging, major complications (including breakthrough pulmonary embolism, migration, fracture, inferior vena cava strictures and pericaval haematoma) were just over 7% for ALN, around 3% for Celect and just over 1% for Celect Platinum filters. Breakthrough pulmonary embolism constituted the largest major complication at nearly 4% for ALN, around 2% for Celect and under 1% for Celect Platinum. Malposition occurred in 22% of ALN filters and in 6–8% of Celect filters.
“Excluding breakthrough pulmonary embolism, the rates of other major complications rates were low. The breakthrough pulmonary embolism rates for each filter, however, were in line with the current literature. Where retrieval was attempted, it was successful in around 98% of ALN filters (although this filter had the highest required rate of advanced retrieval techniques), compared to around 93% of Celect retrievals and over 95% of Celect Platinum filters,” Goh stated.
