Inferior vena cava filter retrieval with radial jaw biopsy forceps: a case report.

Abstract

Background: Inferior vena cava (IVC) filters are used in patients at risk for venous thromboembolism (VTE) who cannot receive anticoagulation. Prolonged dwell times are associated with increased risk of embedment, endothelialization, and retrieval failure, often necessitating advanced techniques. While endobronchial forceps are commonly used in complex retrievals, the role of alternative biopsy devices remains limited. We present the following case highlighting the use of radial jaw biopsy forceps for IVC filter retrieval, a technique with minimal prior documentation.

Case description: A man in his late 30s with a history of recurrent deep vein thromboses presented with progressive bilateral lower extremity swelling and an indwelling IVC filter with an estimated dwell time of approximately 5 years. Imaging demonstrated severe iliocaval obstruction and collateral formation. Initial retrieval attempts using standard snare, loop snare, and hangman techniques were unsuccessful due to fibrotic encapsulation and deformation of the filter. In the absence of rigid endobronchial forceps, radial jaw biopsy forceps were utilized to dissect fibrous tissue and successfully engage and remove the filter. Residual struts were excluded with bilateral iliac vein stenting, resulting in improved venous outflow.

Conclusions: Radial jaw biopsy forceps may serve as a viable alternative in complex IVC filter retrieval when conventional and advanced techniques fail or are unavailable. This case expands the spectrum of available tools and highlights the importance of procedural adaptability in interventional radiology (IR).