Filter tilt, dwell time, and IVC diameter in unsuccessful IVC filter retrieval: associations from a single centre experience over ten years

Abstract Objectives This retrospective cohort study aims to describe management approaches for inferior vena cava (IVC) filter retrieval and identify independent risk factors for unsuccessful retrieval at our tertiary referral centre. Methods All patients who underwent IVC filter insertion at our single tertiary referral centre between February 2016 and August 2025 were included. Kaplan-Meier analysis and a multivariable logistic regression were used to determine rates of retrieval and identify independent risk factors for unsuccessful retrieval. A dedicated database for follow-up of patients with IVC filters was managed by the haematology department. Results A total of 231 patients were included. 103 of 128 (80.47%) retrievals were successful at the first attempt. The retrieval rates at 6 weeks, 3 months, and 1 year were 59.85%, 72.73%, and 81.06%, respectively. On multivariable logistic regression, filter tilt at insertion (p = 0.016), dwell time (p = 0.009), and smaller IVC diameter (p = 0.030) were identified as independent risk factors for unsuccessful retrieval. Conclusions Our follow-up database was instrumental in scheduling early removal and minimising loss to follow-up to achieve high retrieval rates. We advocate for the early removal of filters to maximise successful retrieval, avoid the need for advanced removal techniques, and prevent long-term complications. Advances in knowledge Our findings support hypotheses that prolonged dwell time and greater tilt lead to unsuccessful retrieval and we additionally identify smaller IVC diameter as a previously unreported risk factor. Practically, we provide strong evidence to support the use of a prospectively managed follow-up database for filters.