Rates and Predictors of Plans for Inferior Vena Cava Filter Retrieval in Hospitalized Patients
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Use of inferior vena cava (IVC) filters has been increasing over time. However, because of the increased risk of deep vein thrombosis with permanent filters, placement of retrievable filters has been recommended. Little is known about the factors associated with planned retrieval of IVC filters.
To describe rates and predictors of plans to retrieve IVC filters in hospitalized patients.
We identified all IVC filter placements from 2001–2006 at an academic medical center and reviewed medical charts to obtain data about patient characteristics, filter retrieval plans, and retrieval success rates. Multivariable logistic regression was used to identify independent predictors of planned filter retrieval in patients with retrievable filters.
Out of 240 patients who underwent placement of retrievable IVC filters, only 73 (30.4%) had documented plans for filter retrieval. Factors associated with lower rates of planned filter retrieval included a history of cancer [adjusted odds ratio (OR) and 95% confidence interval 0.2 (0.1–0.5)] and not being discharged on anticoagulants [OR 0.1 (0.1–0.3)]. In addition, 36 (21.6%) of patients without retrieval plans had no contraindications to retrieval. Of the 62 patients who underwent attempted filter retrieval, 25.8% of filters could not be successfully removed.
Only 30.4% of patients who underwent placement of a retrievable IVC filter had documented plans for filter removal. Although most patients had justifiable reasons for filter retention, 21.6% of patients had no clear contraindications to filter removal. Efforts to improve rates of filter retrieval in appropriate patients may help reduce the long-term complications of IVC filters.
- Anderson RC, Bussey HI. Retrievable and permanent inferior vena cava filters: selected considerations. Pharmacotherapy. 2006;26:1595–600. CrossRef
- Crowther MA. Inferior vena cava filters in the management of venous thromboembolism. Am J Med. 2007;120:S13–7. CrossRef
- Imberti D, Ageno W, Carpenedo M. Retrievable vena cava filters: a review. Curr Opin Hematol. 2006;13:351–6. CrossRef
- Baglin TP, Brush J, Streiff M. Guidelines on use of vena cava filters. Br J Haematol. 2006;134:590–5. CrossRef
- Decousus H, Leizorovicz A, Parent F, et al. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prevention du Risque d’Embolie Pulmonaire par interruption cave study group. N Engl J Med. 1998;338:409–15. CrossRef
- Greenfield LJ, The PREPIC Study Group. Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC (Prevention du Risque d’Embolie Pulmonaire par Interruption Cave) Randomized Study. Perspect Vasc Surg Endovasc Ther. 2006;18:187–8. CrossRef
- Stein PD, Kayali F, Olson RE. Twenty-one-year trends in the use of inferior vena cava filters. Arch Intern Med. 2004;164:1541–5. CrossRef
- British Committee for Standards in Haematology, Writing G, Baglin TP, Brush J, et al. Guidelines on use of vena cava filters. Br J Haematol. 2006;134:590–5. CrossRef
- Grande WJ, Trerotola SO, Reilly PM, et al. Experience with the recovery filter as a retrievable inferior vena cava filter. J Vasc Interv Radiol. 2005;16:1189–93.
- Seshadri T, Tran H, Lau KK, et al. Ins and outs of inferior vena cava filters in patients with venous thromboembolism: the experience at Monash Medical Centre and review of the published reports. Intern Med J. 2008;38:38–43.
- Yamagami T, Kato T, Iida S, et al. Gunther tulip inferior vena cava filter placement during treatment for deep venous thrombosis of the lower extremity. Cardiovasc Intervent Radiol. 2005;28:442–53. CrossRef
- Terhaar OA, Lyon SM, Given MF, et al. Extended interval for retrieval of Gunther Tulip filters. J Vasc Interv Radiol. 2004;15:1257–62.
- Bovyn G, Ricco JB, Reynaud P, et al. Long-duration temporary vena cava filter: a prospective 104-case multicenter study. J Vasc Surg. 2006;43:1222–9. CrossRef
- Oliva VL, Szatmari F, Giroux MF, et al. The Jonas study: evaluation of the retrievability of the Cordis OptEase inferior vena cava filter. J Vasc Interv Radiol. 2005;16:1439–45. quiz 1445.
- Millward SF, Oliva VL, Bell SD, et al. Gunther Tulip Retrievable Vena Cava Filter: results from the Registry of the Canadian Interventional Radiology Association. J Vasc Interv Radiol. 2001;12:1053–8. CrossRef
- Asch MR. Initial experience in humans with a new retrievable inferior vena cava filter. Radiology. 2002;225:835–44. CrossRef
- Imberti D, Bianchi M, Farina A, et al. Clinical experience with retrievable vena cava filters: results of a prospective observational multicenter study. J Thromb Haemost. 2005;3:1370–5. CrossRef
- Wicky S, Doenz F, Meuwly JY, et al. Clinical experience with retrievable Gunther Tulip vena cava filters. J Endovasc Ther. 2003;10:994–1000. CrossRef
- Marquess JS, Burke CT, Beecham AH, et al. Factors associated with failed retrieval of the Gunther Tulip inferior vena cava filter. J Vasc Interv Radiol. 2008;19:1321–7. CrossRef
- Hermsen JL, Ibele AR, Faucher LD, et al. Retrievable inferior vena cava filters in high-risk trauma and surgical patients: factors influencing successful removal. World J Surg. 2008;32:1444–9. CrossRef
- Chiou AC, Biggs KL, Matsumura JS. Vena cava filters: why, when, what, how? Perspect Vasc Surg Endovasc Ther. 2005;17:329–39. CrossRef
- Streiff MB. Vena caval filters: a comprehensive review. Blood. 2000;95:3669–77.
- Ray CE Jr, Kaufman JA. Complications of inferior vena cava filters. Abdom Imaging. 1996;21:368–74. CrossRef
- Gelbfish GA, Ascer E. Intracardiac and intrapulmonary Greenfield filters: a long-term follow-up. J Vasc Surg. 1991;14:614–7. CrossRef
- James KV, Sobolewski AP, Lohr JM, et al. Tricuspid insufficiency after intracardiac migration of a Greenfield filter: case report and review of the literature. J Vasc Surg. 1996;24:494–8. CrossRef
- Karmy-Jones R, Jurkovich GJ, Velmahos GC, et al. Practice patterns and outcomes of retrievable vena cava filters in trauma patients: an AAST multicenter study. J Trauma. 2007;62:17–24. discussion 24–15. CrossRef
- FitzPatrick MK, Reilly P, Stavropoulos SW. The use of retrievable inferior vena cava filters in trauma: implications for the trauma team. J Trauma Nurs. 2006;13:45–51. quiz 52–43.
- Ray CE Jr, Mitchell E, Zipser S, et al. Outcomes with retrievable inferior vena cava filters: a multicenter study. J Vasc Interv Radiol. 2006;17:1595–604. CrossRef
- Kirilcuk NN, Herget EJ, Dicker RA, et al. Are temporary inferior vena cava filters really temporary? Am J Surg. 2005;190:858–63. CrossRef
- Allen TL, Carter JL, Morris BJ, et al. Retrievable vena cava filters in trauma patients for high-risk prophylaxis and prevention of pulmonary embolism. Am J Surg. 2005;189:656–61. CrossRef
- Rates and Predictors of Plans for Inferior Vena Cava Filter Retrieval in Hospitalized Patients
Journal of General Internal Medicine
Volume 25, Issue 4 , pp 321-325
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- inferior vena cava
- filter retrieval
- deep vein thrombosis
- Industry Sectors
- Author Affiliations
- 1. The University of California San Francisco School of Medicine, San Francisco, CA, USA
- 2. Section of Interventional Radiology, the University of California San Francisco, San Francisco, CA, USA
- 3. Department of Radiology, the University of California San Diego, San Diego, CA, USA
- 4. Division of Hospital Medicine, the University of California San Francisco, 503 Parnassus Ave., Box 0131, San Francisco, CA, 94143, USA