Clinical comparison of two optional vena cava filters

Abstract

PURPOSE: To compare the clinical safety and efficiency of two optional inferior vena cava (IVC) filters. MATERIAL AND METHODS: Ninety-three consecutive Günther Tulip filters (92 patients) were compared with 83 consecutive OptEase filters (80 patients). Filters were placed at the same institution in patients with high-risk multiple trauma or those undergoing neurosurgery with contraindications to primary prophylaxis (70 patients in the Günther Tulip group and 44 in the OptEase group) and in patients with venous thromboembolism and contraindications to anticoagulation (22 patients in the Günther Tulip group and 36 in the OptEase group). The filters were placed in an angiography suite. Catheter vena cavography was performed before filter placement and intended retrieval. Permanent filters were followed-up with duplex ultrasonography and conventional radiography. RESULTS: All filters were inserted infrarenally without any complications. Fluoroscopy times for placement and retrieval were longer for the Günther Tulip group than the OptEase group. The mean dwelling time was 11 days (range, 3-27 days) for the Günther Tulip filters and 13.8 days (range, 1-34 days) for the OptEase filters. No symptomatic pulmonary emboli (PE) occurred in patients with intended temporary filtration while the devices were in place. Forty-six of the 93 Günther Tulip filters (49%) and 58 of the 83 OptEase filters (70%) were removed. Two Günther Tulip filters could not be retrieved for technical reasons. The mean follow-up for the permanent Günther Tulip (n = 19) and OptEase (n = 8) filters was 41 and 7 months, respectively. One patient from each group had late caval thrombosis. There were no cases of filter migration or disintegration. CONCLUSION: Both optional IVC filters are safe and seem to prevent symptomatic PE. On the basis of the fluoroscopy times, the OptEase filters appear to be more operator-friendly. Late filter-associated complications are rare with these filter designs.