Feasibility and safety of right subclavian vein as an alternative route for retrieval of temporary inferior vena cava filters.

Abstract

ObjectiveIn patients with occlusion or severe stenosis of the internal jugular vein, the retrieval of temporary inferior vena cava (IVC) filters often proves technically challenging. This study was designed to evaluate the feasibility and safety of the right subclavian vein (SCV) as an alternative access route for retrieving temporary IVC filters.MethodsPatients treated with inferior vena cava (IVC) filters were included in a retrospective analysis between August 2023 and May 2025. A total of 87 eligible patients were divided into two separate groups based on the puncture route; right subclavian vein (SCV) group and internal jugular vein (IJV) group. A retrospective analysis was performed on their patient demographics, operative duration, radiation dose, costs, and postoperative recovery time.ResultsNotable statistical disparities were detected between the two groups in primary disease, operative time, fluoroscopy time, and radiation dose. Compared with the internal jugular vein (IJV) group, the right subclavian vein (SCV) group exhibited a higher prevalence of primary malignant diseases, along with a mean 7.35-min increase in operative time, 127-s longer fluoroscopy time, and 14.11-mGy higher radiation dose. Follow-up CT assessments revealed sustained patency of the subclavian veins in the right subclavian vein (SCV) group, with no instances of thrombosis or stenosis observed during the postoperative period, or any life-threatening pneumothorax or bleeding was detected.ConclusionsThe right subclavian vein (SCV) approach is suggested as a safe and effective alternative, especially when the internal jugular vein (IJV) is severely stenosed or occluded. For temporary inferior vena cava (IVC) filter retrieval, the conventional internal jugular vein (IJV) route is recommended; however, the right subclavian vein (SCV) may be considered a clinically appropriate alternative in specific indications, without significantly increasing procedural difficulty or surgical costs.