Overview
The Cook Celect Platinum IVC Filter (Cook Medical) is a retrievable inferior vena cava filter designed for the prevention of pulmonary embolism in patients with contraindications to anticoagulation or breakthrough PE despite therapeutic anticoagulation. It is one of the most widely implanted IVC filters in the UK NHS.
Indications
Acute VTE with absolute contraindication to anticoagulation (e.g., active haemorrhage, recent surgery)
Recurrent PE despite adequate anticoagulation
Prophylactic placement before high-risk surgery in patients with recent VTE
Massive iliofemoral DVT with free-floating thrombus
Trauma patients with high VTE risk unable to receive prophylaxis
Specifications
| Parameter | Detail |
|---|---|
| Material | Conichrome (cobalt-chromium-nickel alloy) with platinum markers |
| Max IVC diameter | 30 mm |
| Delivery sheath | 7 Fr (femoral or jugular approach) |
| Retrieval window | Up to 510 days (manufacturer data), but retrieve as early as possible |
| MRI conditional | Yes — 3T, immediately after implantation |
Key Features
Low-profile 7 Fr delivery — allows both femoral and jugular deployment
Retrievable design — hook at the apex engages with a dedicated retrieval cone/snare
12 legs with anchoring barbs — four primary struts with secondary struts for filtration and anchoring
Platinum tip marker — aids fluoroscopic visualisation during retrieval
Technique Tips
Perform a cavogram before deployment to measure IVC diameter, identify variants (duplicated IVC, circumaortic renal vein), and confirm renal vein positions.
Deploy the filter immediately below the renal veins. Mark the lowest renal vein with a pigtail catheter for reference.
For jugular access, the filter is deployed apex-down (reversed orientation). Ensure the correct orientation kit is selected.
Always plan retrieval at the time of insertion. Place a note in the patient record and set a retrieval review date.
Retrieval: Use a rigid 12 Fr sheath with a snare or dedicated retrieval set. Engage the hook, collapse into the sheath, and withdraw as a unit.
If the filter has tilted or is embedded, advanced retrieval techniques (laser sheath, forceps, endobronchial forceps) may be needed — refer to an experienced centre.
Important Considerations
Retrieve early — NICE and CIRSE guidelines recommend retrieval as soon as the indication has resolved, ideally within 4–6 weeks.
Complications of long-term filters — IVC thrombosis, filter migration, strut perforation, and fracture increase with dwell time.
Suprarenal placement may be required if thrombus extends above the renal veins, in pregnancy, or with IVC anomalies.