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2156. Inferior Vena Cava Placement and Retrieval in Pediatric Patients: A Multicenter Retrospective Analysis
Authors * Denotes Presenting Author
  1. Joel Raborn *; University of Alabama at Birmingham
  2. Eric Monroe; Seattle Children's Hospital
  3. Aparna Annam; Colorado Children's
  4. Patricia Ladd; Colorado Children's
  5. Victoria Young; Stanford University
  6. Matt Lungren; Stanford University
  7. Andrew Gunn; University of Alabama at Birmingham
Objective:
To assess utilization, technical parameters, and clinical outcomes of IVCF placement and retrieval in pediatric patients.

Materials and Methods:
Multi-institutional retrospective review of IVCF placement and retrievals in pediatric patients (= 21 years old). Demographic information, placement indications, type of filter, technical parameters of placement, IVCF-related complications, attempts at retrieval, technical parameters of retrieval, and retrieval-related complications were recorded.

Results:
88 patients (45 male (51%); 43 female (49%); mean age: 17.3 (range: 4-21) were included. Indications for placement included a contraindication to anticoagulation (n=46, 52%), thrombolysis/thrombectomy procedure (n=28, 32%), pulmonary embolism prophylaxis without deep venous thrombosis (n=10, 11%), and failure of anticoagulation (n=4, 5%). 100% of the IVCFs were optional/retrievable. Technical success of placement was 100% with no procedural complications. One patient experienced ileocaval thrombosis and caval penetration of a filter strut into the pancreatic duct causing abdominal pain requiring prolonged admission (SIR Grade D). 63 patients (72%) underwent attempt at retrieval, 10 patients (11%) were lost to follow up, 7 patients (8%) died prior to retrieval, 4 patients (5%) had IVCFs left as permanent devices, and 4 patients (5%) were still under evaluation at the time of data collection. For patients that underwent retrieval attempts, median dwell time was 38.5 days (range: 1-2778, SD: 417). 84% (n=53) were on anticoagulation at the time of retrieval. Retrieval was successful in 95% of cases (n=60). Techniques employed during retrieval included endovascular snare (n=57, 90%), wire-loop snare technique (n=3, 5%), endobronchial forceps (n=2, 3%), and laser-sheath assisted removal (n=1, 2%) (1). There were no complications at retrieval.

Conclusion:
IVCF placement is safe in pediatric patients with a low rate of filter-associated complications. Rates of retrieval are higher than reported in the adult population (2) although with similar rates of technical success of retrieval and retrieval-associated complications (3).