Surgical and Interventional Considerations in the Retrieval of the CelectTM Inferior Vena Cava Filters

Although inferior vena cava filters (IVCFs) are a known method for caval interruption and prevention of pulmonary embolism (PE), there is a lack of controlled trials conclusively proving that IVCF placement actually reduces the risk of PE or death. Additionally, their use has become a far more common practice since the development of retrievable IVCFs. The rationale for the use of retrievable IVCFs is that they provide the theoretical benefit of protection from PE, while allowing their removal when they are no longer needed, thus resulting in fewer long-term complications. Unfortunately, it is a fact that the majority of retrievable IVCFs are not removed and that they are associated with significant complications, most notably vena cava perforation and thrombosis. The Celect retrievable IVCF (Cook Medical, Bloomington, IN) is one of the systems available in the United States for caval interruption. This manuscript describes three challenging cases of retrieval of Celect IVCFs. The first is the case of a young female who developed late complications related to a retrievable Celect IVCF that caused infrarenal caval occlusion and perforation into the surrounding retroperitoneal structures. She ultimately required open surgical filter retrieval. In addition, we also describe two patients in which alternative percutaneous methods for IVCF retrieval were used. We briefly review the literature concerning indications for IVCF placement and some of the pitfalls that can be encountered while attempting their retrieval. Further studies are necessary to investigate the efficacy and outcomes of retrievable IVCFs.