Vena cava filters are placed for treatment of deep vein thrombosis and/or pulmonary embolism. Complications arising from the placement of these filters include migration, dislodgment, vena cava penetration, and vena cava thrombosis. One additional complication that has been increasing in frequency but is completely preventable is the ensnarement of the filter by guidewires being used to insert central venous catheters from the subclavian, jugular, and femoral approaches.

There are a variety of vena cava filters available in the United States. Some of the more commonly used filters include the Green field (both titanium and stainless steel models), Simon Nitinol, Bird’s Nest, Vena Tech LGM, Vena Tech TrapEase, and Gunther Tulip filters. Despite design differences, they are all similar in that they allow venous flow through the filter while capturing emboli via the radiating struts of the filter.

There are various guidewires that are used during the Seldinger technique, including straight guidewires and the more commonly encountered 1.5-, 3-, and 15-mm J-tip guidewires packaged in central venous catheter insertion kits (the number describes the radius of the curve of the J-tip). In vitro studies and case reports show that ensnarement of the guidewire in the filter struts is possible with all diameters of the J-tip guidewire used in placing central venous catheters and does not occur with straight guidewires. The filters with the highest likelihood of ensnaring the J-tip guidewires are the Green field and Vena Tech filters with only the Gunther Tulip reported as not entrapping the J-tip guidewire.