New technique to prevent tilt during inferior vena cava filter placement.

Abstract

The risk of inferior vena cava (IVC) filter tilt during placement is significant and may limit filter retrieval. The purpose of the study was to determine if tilting of IVC filters on deployment is able to be reduced when using a femoral approach. Under fluoroscopic guidance, Cook Celect IVC filters that are not in axis with the IVC prior to full deployment were straightened in the long IVC axis using a stiff guidewire prior to release. This guidewire helps to center the apex of the filter in the IVC and allow proper deployment. All 11 IVC filters deployed with this technique have been placed without tilt. No complications were encountered with this technique. IVC filter tilt may lessen their efficacy and ability to be easily retrieved. By using this technique, we have virtually eliminated IVC filter tilt in our patients.