The U.S. Food and Drug Administration (FDA) authorized marketing of the first laser-based device for the removal of Inferior Vena Cava (IVC) filters. The device is designed for patients who have an IVC filter, a small cage-like device inserted into the largest vein in the body to capture blood clots and prevent them from traveling to the lungs.
The new device, called the Philips CavaClear Laser Sheath, is intended for the removal of tissue to facilitate detachment of an IVC filter during retrieval when previous methods of removal have failed.
IVC filters are commonly used to treat patients who are at risk for pulmonary embolism (a blood clot in the lungs) when treatment with blood thinners cannot be used or is ineffective. While some IVC filters are left in place permanently, the FDA issued a safety communication in 2014 based on reports of adverse events associated with IVC filters and recommended that implanting physicians consider removing the filter as soon as blood clots are no longer a risk for the patient.
During removal, the Philips CavaClear Laser Sheath device is designed to facilitate detachment of firmly adherent IVC filters from the IVC wall using ultraviolet laser energy to remove a small amount of the tissue. The device is designed for use in conjunction with conventional snare devices to assist in IVC filter removal.
The FDA assessed the safety and effectiveness of the device through a retrospective, real-world evidence clinical study. The study, which evaluated laser-assisted IVC filter removal in 265 patients at seven clinical sites, demonstrated a procedural technical success rate of 96%. The study had a 3% rate of significant device-related complications, including IVC injury causing extravasation (bleeding), hematoma formation (bleeding outside of the blood vessel), and filter breakage.
Use of the Philips CavaClear Laser Sheath device is contraindicated when a blood clot is present within the filter or surrounding veins, when the IVC filter is not accessible, or when the filter is nonmetal. The device may not be used in removal of Bird’s Nest IVC filters and VenaTech IVC filters.
The Philips CavaClear Laser Sheath was granted a Breakthrough Device Designation for the removal of IVC filters. The Breakthrough Devices Program is a process designed to expedite the development and review of devices that may provide for more effective treatment or diagnosis of life-threatening or irreversibly debilitating diseases or conditions and that otherwise meet the statutory criteria for Breakthrough Device Designation.
