Feasibility and safety of “filter-thrombus integrated retrieval technique” based on controlled deformation of spindle shaped IVC filters for complex IVC filter retrieval

TL;DR

A new technique for safely removing blood clots from IVC filters is shown to be effective and safe in patients with complex clotting.

Contribution

The novel 'filter-thrombus integrated retrieval technique' enables en bloc removal of thrombosed filters without additional devices.

Findings

The technique achieved a 100% technical success rate in 51 patients.

Only 7.8% of patients developed asymptomatic pulmonary embolism post-procedure.

No major complications like venous avulsion or hemorrhage occurred.

Abstract

To evaluate the safety and feasibility of the “filter-thrombus integrated retrieval technique,” which leverages the controllable deformation characteristics of spindle-shaped inferior vena cava (IVC) filters, for the retrieval of filters with thrombus burden.

A retrospective analysis was conducted on clinical data from 51 patients with IVC filter thrombosis (IVCFT) treated at our center from September 2023 to September 2025. All patients underwent retrieval using the “filter-thrombus integrated retrieval technique” to construct a “filter-thrombus complex” for en bloc removal. Preoperative 3D-DSA was employed to quantitatively assess thrombus volume. The primary endpoint was the technical success rate. Secondary endpoints included the incidence of pulmonary embolism (PE) and procedure-related complications.

The mean filter dwell time was 35.25 ± 5.80 days. 3D measurements revealed a mean thrombus volume of 4.60 ± 0.42 cm3, with 13 cases classified as severe thrombus burden. The technical success rate was 100% (51/51). No symptomatic PE occurred postoperatively. Routine CTPA screening detected asymptomatic, minor PE in 4 patients (7.8%), all of which resolved following anticoagulation. No serious complications, such as venous avulsion or major hemorrhage, were observed.

The filter-thrombus integrated retrieval technique appears to be a safe and feasible strategy for managing thrombosed filters. Through a unique physical “caging” mechanism, this technique minimizes the risk of iatrogenic PE during retrieval without relying on additional thrombolysis or aspiration devices. It presents a viable option for patients with high thrombus burden or contraindications to anticoagulation.

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