The Celect Platinum Inferior Vena Cava Filter

T he concept of surgical caval interruption was suggested as early as 1868 by Trousseau, who proposed creating a barrier in the inferior vena cava (IVC) to prevent venous emboli from the legs from reaching the lungs.1 In 1967, nearly 100 years later, the first endovenous filter was implanted.2 Although the basic concept of caval filtration has largely remained the same over the past century, advancements in metallurgy, filter design, retrievability, and imaging have greatly expanded the use of IVC filters. In the United States, there are currently at least 14 types of IVC filters available to physicians, and of these, at least six filters are retrievable. Since 2010, there has been increased scrutiny on filters by the US Food and Drug Administration (FDA) regarding device migrations, fractures, caval thrombosis, caval penetration, and filter tilt.3 Thus, since 2011, after a decade-long progressive increase in filter placement volume, annual filter placement volumes began declining. The breadth of clinical literature generally supports the safety and efficacy of IVC filters, although the designs of filters and their delivery systems continue to evolve to tackle the admittedly rare, yet potentially catastrophic, complications. Furthermore, evolutionary changes to IVC filter designs and filter delivery systems have been ongoing. These changes have been incorporated to improve filter placement by reducing tilt, penetration, and migration, with the overall goal of easing subsequent filter retrieval. This article describes our early experience with the newest-generation Celect Platinum IVC filter (Cook Medical).