Removing the Angled Inferior Vena Cava Filter with an Embedded Hook: The “Hangman” Technique

Multiple advanced techniques for the retrieval of difficult inferior vena cava (IVC) filters have been published in the literature, most of which describe mechanical methods to disrupt the fibrous capsule in cases in which the filter hook or struts have become embedded in the IVC wall. Despite reported high success rates, these techniques often require multiple venous access sites or the use of special equipment. The “hangman” technique is a modified “loop snare” technique that requires only a single venous access and uses standard interventional equipment. It modifies the loop snare technique by passing the wire loop between the filter neck and IVC wall, as opposed to the filter. This chapter elaborates on the hangman technique and its applications and steps.