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Strut perforation over time for the celect vena cava filter-2:06 PM Abstract No. 179

Authors
Journal
Journal of Vascular and Interventional Radiology
1051-0443
Publisher
Elsevier
Volume
25
Issue
3
Identifiers
DOI: 10.1016/j.jvir.2013.12.241
Disciplines
  • Medicine

Abstract

Purpose Evaluate the perforation rate for the Celect IVC filter in our study population and its relationship to progressive strut perforation. Materials and Methods Retrospective, IRB-approved review of 91 patients with at least 3 computed tomography (CT) studies after infrarenal placement of a Celect IVC filter at our institution between 1/1/2007 and 6/1/2013. Filter strut perforation and the number of struts (primary and secondary) perforating the IVC (strut >3 mm outside caval wall) were evaluated on each of the 3 follow-up CT studies by two independent radiologists (Kappa statistics). The patients were then split into three groups based on the presence of strut perforation and if additional struts perforated over time. Perforation rates in different gender and malignancy status groups were compared (Z-test). Results Interobserver agreement between the two radiologists was excellent (weighted Kappa = 0.94). The 91 patients were divided into three groups: A, no perforation, n = 19, (21%); B, perforation without progression, n = 7, (8%); and C, perforation with progression, n = 65, (71%). Average days from filter placement to last follow-up CT study (for each group: A = 203; B = 708; C = 634) for all patients was 549 days. Although 33 (36%) of 91 filters demonstrated perforation on initial follow-up CT, 65 patients (71%) demonstrated progression of perforation over time with 72 (79%) of patients showing perforation by final follow-up CT. Patients with a history of malignancy had a higher rate of perforation compared to those without (85% vs. 65%, p = 0.03) at final CT. Females had a higher rate of perforation than males, but the difference was not significant due to the small population size (86% vs. 72%, p = 0.10). Conclusion In our study population, the majority of Celect IVC filters will eventually perforate the inferior vena cava on late imaging follow-up. The number of perforating struts also increases over time. A positive malignancy status may increase the risk of strut perforation.

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