Femoral Retrieval of Conical Filters

Inferior vena cava (IVC) filters are a safe, effective treatment option for the prevention of pulmonary embolism in patients who either have contraindication to or fail anticoagulation. However, filters pose long-term risks, such as IVC thrombosis, deep vein thrombosis, penetration of the IVC wall, filter fracture, and filter migration. IVC filters should be retrieved once the indication for placement has passed. However, cervical access frequently becomes compromised. This chapter reviews strategies for retrieving IVC filters from a femoral approach. Various techniques are discussed, including snaring the filter struts and the use of bilateral femoral sheaths to recapture the IVC filter.