SUCCESSFUL DEMONSTRATION OF USING ENDOVASCULAR FORCEPS ALONG WITH A TRADITIONAL SNARE TO SAFELY RETRIEVE EMBEDDED/TITLED INFERIOR VENA CAVA IN A LOCAL COMMUNITY HOSPITAL

Abstract

Purpose: Measure successfulness of retrieving tittle/embedded IVC filters with a rigid endovascular forceps along with a traditional snare in a local community hospital.  

Technique: The technique is demonstrated among 18 patients from an inner city community hospital. Retrieval attempts were performed via right internal jugular vein access. A 5 French sheath was placed, through which a guidewire and catheter were placed below the filter and a cavogram performed. After the present of an IVC was confirmed, a 10 French sheath was placed through the existing access and an 18-30mm snare device was used to grasp the filters. The snare device was exchanged for a 12 French 40 cm sheath after several unsuccessful attempts to grasp the filter hook. An endovascular forceps was then advanced through the sheath and repositioned the filter hook more centrally in the IVC. The forceps was removed and then an snare device was used again to engage the hook of the filter.  The 12 French sheath was advanced over the filter while maintaining the traction with the snare and both sheath and filter were removed successfully.

Conclusion: Recruiting endovascular forceps technique in combination with a traditional snare can be used safely to retrieve tilted/embedded IVC Filter in a community based hospital.