Evaluation of retrievability of the Gunther tulip vena cava filter.

PURPOSE: To evaluate the feasibility and safety of withdrawal of a Gunther tulip retrievable vena cava filter (GTF).

METHODS: Between June 2001 and December 2005, at our institution 86 GTFs were implanted for temporary caval filtration in 59 patients (37 women, 22 men; mean age 59.3 years, range 18-87 years). For GTFs retrieved thereafter, we retrospectively reviewed the following parameters: rate of success in retrieval, degree of trapped thrombus in the filter, and complications during retrieval.

RESULTS: Worsening of or new development of pulmonary embolism after filter implantation did not occur in any patient. Of the 86 GTFs implanted, retrieval of 80 was attempted. Among those 80 filters, 77 (96%) were successfully retrieved (with the standard method, n = 72; with the modified method, n = 5) without any complication. The period of implantation of the retrieved filters was 13.4 +/- 4.2 days. In the 5 filters that were filled to a height of > or = 1/4 with trapped thrombus, retrieval was performed after attempts were made to decrease trapped thrombi. In addition, a temporary filter or another GTF was temporarily placed at the cephalad level of the GTF during this removal procedure.

CONCLUSION: GTFs can be retrieved in the majority of cases. Even when encountering situations in which the filter could not be removed using the standard method, withdrawal was possible in a high frequency of cases through various trials using modified methods.