AVF Journal Club: Denali IVC Filter Trial and Cost Study

FINAL Denali Trial: High Clinical and Retrieval Success

Across 200 patients at 21 sites, the Denali filter achieved 95 percent clinical success with zero recurrent lethal pulmonary embolism, 121 of 124 attempted retrievals succeeded, and average dwell time was about 200 days with low complication rates.

Study Limitations: Single-Arm Design and Follow-Up Gaps

Panelists noted the study lacked routine imaging to detect asymptomatic PE, relied partly on phone follow-up, and forty percent of enrolled patients had no confirmed thromboembolic disease, likely inflating apparent success.

Denali Versus Option: Retrieval Success and Long-Term Cost

Comparing 52 Denali and 35 Option filters, Denali showed significantly less tilt and hook embedment and higher first-attempt retrieval success; despite a higher upfront price, its total cost was lower once secondary retrieval attempts were counted.

Clinical Pearls: Retrieval Technique and Patient Tracking

Panelists start with a simple loop snare, escalate to forceps or balloon techniques before considering laser as a last resort, and use scheduled follow-up appointments or retrieval reminder bracelets to reduce prolonged unnecessary dwell time.