Fig. 4

This patient had an Argon Option Elite filter (Argon Medical Devices, Plano, TX) placed 3 months prior to attempted retrieval. Significant rightward apical tilt was seen on initial venogram retrieval precluding snaring of the hook. The sling technique was then employed. The filter was then pulled cranially resulting in significant leftward tilt and eventually entered the left renal vein. This caused acute left renal vein thrombosis. A suprarenal filter was placed. 3 main lessons can be gleaned from this case: 1-filters should not be “pulled” but rather should be over sheathed, 2-when using the sling technique, at least two legs should be engaged, 3-consideration should be given to using the modification of the sling technique where-by, the sling is used only to realign the filter allowing the hook to become accessible and subsequently snared in a standard fashion