This instructional video provides a comprehensive overview of Denali™ IVC filter retrieval. Designed for clinicians and clinical education teams, it outlines the essential procedural steps, device characteristics, and key considerations for safe and effective filter removal. Through clear narration and detailed visuals, the video highlights procedural concepts, technical insights, and real-world application.
The barred snare retrieval kit is intended to percutaneously remove all barred optional vena cava filters with a single retrieval hook. The retrieval kit includes a single loop snare and two catheters for use with either a dual or single sheath retrieval technique, depending on the barred optional vena cava filter being retrieved. Select a suitable jugular venous access route on either the right or left side, depending upon the patient's size or anatomy, operator's preference, or location of venous thrombosis. Introduce the dilator, retrieval sheath and access sheath assembly over the wire such that the tip of the sheath is approximately 3 centimeters cephalad to the filter retrieval hook. Insert and advance the snare assembly with retracted snare loop inside the snare catheter through the hemostatic valve and retrieval sheath until it protrudes out of the sheath such that the marker band of the snare catheter is cephalad to the filter retrieval hook. Advance the snare until the 20 millimeter loop has fully expanded above the filter retrieval hook. Slowly advance the snare loop forward over the filter retrieval hook. Reduce the loop diameter by advancing the snare catheter while simultaneously pulling the snare backwards until the loop engages the filter retrieval hook. Under fluoroscopic guidance, ensure that the loop of the snare has properly engaged the retrieval hook and that the retrieval hook, retrieval catheter, and snare are aligned. Be careful to snare the apex of the retrieval hook, not the side. The marker band of the snare catheter must be cephalad to the filter retrieval hook. Always maintain tension on the snare to prevent disengagement of the snare loop from the retrieval hook. Advance the retrieval sheath in the caudal direction until it covers half of the filter. Care should be taken when advancing the 9 French sheath in the caudal direction to avoid completely covering the arms and legs of the filter. While keeping tension of the snare, hold the retrieval sheath stationary and withdraw the filter into the sheath by retracting the snare. Retract the snare until the filter and cranial anchors are completely contained inside the retrieval sheath. Once the filter is fully collapsed inside the retrieval sheath, retract the filter, snare, and retrieval sheath as one unit out through the 11 French access sheath.
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