Today's Case 9 - IVC Filter Removal : How To Remove Filter Without Snaring Hook

IVC filter removal : how to remove filter without snaring hook

A patient who had an IVC filter inserted three weeks ago came to the procedure room for filter removal. Having no prior personal experience with filter removal, I reviewed several cases before entering the procedure room.

The sheath insertion proceeded without complications. We used a Cook Celect filter and Cook removal set for the procedure. When attempting to capture the filter with a snare, I encountered difficulty as I was not familiar with the technique and couldn’t retrieve the snare from the snare sheath. As a result, I ended up passing by the filter without successful snaring.

I retrieved the snare catheter and attempted hook snaring after a few checks. Due to somewhat forceful attempts, I unintentionally touched the filter with the snare catheter several times, which, in my opinion, might have been a contributing factor to the situation.

Despite about 30 minutes of attempts, hook snaring did not work effectively, and eventually, the snare got entangled with one of the filter’s legs and got damaged. Unfortunately, I did not take pictures of this incident due to my inexperience.

The following content describes Professor Kim’s arrival and the remarkable method he used to successfully remove the filter

IVC filter in IVC center — Initial asceding venography (8cc/sec, total 15cc) which exhibit filter located at center of IVC.

The hook doesn’t catch on the snare despite repeated attempts

Place the Omni catheter under the filter, then insert the snare alongside the Omni catheter from the sheath to capture the Terumo GW that has come out of the Omni catheter. Create a loop using the snare to capture the filter