What is a recovery nitinol inferior vena cava (IVC) filter?

Updated: Oct 31, 2020
  • Author: Gary P Siskin, MD; Chief Editor: Kyung J Cho, MD, FACR, FSIR  more...
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Answer

Recovery nitinol filter

The Recovery filter was approved by the FDA in 2003, but it is no longer available commercially and has been replaced by the G2/G2 X filters (discussed further below).

The Recovery filter is made from nitinol and is MRI-compatible. Similar to the Simon nitinol filter, it has 2 levels of filtration using 6 radiating arms and legs, each of 0.13-in nitinol wires. The legs have hooks for anchoring. The maximum diameter of the extended filter legs is 32 mm; it is approved for use in IVCs of up to 28 mm in diameter. The deployed height is 40 mm. The delivery system is of 7F ID (9F OD) through the femoral approach.

Retrieval is via a specific retrieval cone supplied as a separate kit. The system is introduced via the jugular route with a 12F sheath. The 20-mm cone has 9 steel struts within a urethane membrane with a base diameter of 15 mm when opened.

Asch reported successful retrieval of the Recovery filter without complications in 24 patients with a mean implantation period of 53 days (range, 5-134 d). [75] One migration of 4 cm occurred with a large, trapped thrombus. Grande et al reported recurrent PE in 2.8% of 106 Recovery filters placed [76] ; 14 filters were retrieved successfully from this group.

Kalva et al report their experience in 96 patients, in which retrieval was successful in 9 of 11 attempted patients. [77] The average indwell time was 117 days (range, 24-426d). On abdominal CT scan in 40 of the 96 patients, 12 (30%) showed clumping of the filter legs, and 11 (27.5%) showed penetration of the IVC walls.

In a series of 14 patients, Hull and Robertson reported arm perforation in 5 of 9 (56%) and leg perforation in 1 of 9 (11%) on early CT imaging (mean, 30 d; range, 0-126 d) and in all patients during final imaging (mean, 899 d; range, 119-1218 d). [78] They reported limb fracture and migration in 3 of their 14 patients (21%) and successfully performed late-stage retrieval on all the filters. [78] Cantwell et al reported 6 filter fractures in 128 patients. [79]


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