Inferior Vena Cava Filters and Their Varying Compliance with the ACCP and the SIR Guidelines

Sader, Roula Bou; Friedman, Adie; Berkowitz, Eric; Martín, E

doi:10.14423/smj.0000000000000164

Cited by 8 publications

(3 citation statements)

References 1 publication

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“…placement. Furthermore, these guidelines are often not rigorously followed, with filter placement indications varying widely between institutions [15][16][17]. Filters were initially intended for use in patients with VTE and either a contraindication to anticoagulation, a complication of anticoagulation, or a failure of anticoagulation, so-called absolute or "classic" indications [1,18].…”

Section: Devicesmentioning

confidence: 99%

ACR Appropriateness Criteria® Radiologic Management of Venous Thromboembolism-Inferior Vena Cava Filters

Minocha

Smith

Kapoor

et al. 2019

Journal of the American College of Radiology

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Venous thromboembolism (VTE)-deep vein thrombosis and pulmonary embolism-is a common cause of morbidity and mortality. The mainstay of VTE prophylaxis and therapy is anticoagulation. In select patients with VTE, inferior vena cava (IVC) filters are used to prevent pulmonary embolism by trapping emboli as they pass from the lower extremity venous system through the IVC. These guidelines review the indications for placement of IVC filters in acute and chronic VTE, as well as the indications for retrieval of implanted IVC filters.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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Section: Devicesmentioning

confidence: 99%

ACR Appropriateness Criteria® Radiologic Management of Venous Thromboembolism-Inferior Vena Cava Filters

Minocha

Smith

Kapoor

et al. 2019

Journal of the American College of Radiology

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“…Risk stratification for PTE was performed using Caprini classification preoperatively, and mechanical prophylaxis (i.e., intermittent pneumatic compression) was performed according to the indication. Pharmacological prophylaxis (i.e., heparinization) was not selected due to the nature of surgery, in which excessive bleeding was anticipated [13,14].…”

Section: Surgerymentioning

confidence: 99%

The safety and validity of surgical resection for hemodialysis-dependent patients with renal cell carcinomas involving the inferior vena cava

et al. 2016

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Perioperative morbidity and mortality increase during renal cell carcinoma resection with inferior vena cava involvement in hemodialysis-dependent end-stage renal disease patients. We evaluated the safety and validity of surgical management for renal cell carcinoma with inferior vena cava thrombi in such patients undergoing radical nephrectomies and tumor thrombectomies. There were three patients with tumor thrombus level II, and one each with tumor thrombus level III and IV. We evaluated median operative time (337 min), median estimated blood loss (1300 mL), and median postoperative hospitalization (15 days). Postoperative complications included surgical site dehiscence and pulmonary thromboembolism. One patient with preoperatively identified lung metastases developed a pulmonary thromboembolism on day 3 and died on day 15. The other four patients had long postoperative survival (19-104 months). Successful surgical management of renal cell carcinoma involving the inferior vena cava requires preoperative evaluation of the patient's condition to improve survival for hemodialysis-dependent end-stage renal disease patients.

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“…Two recent publications focused on compliance with the Society of Interventional Radiology (SIR) and American College of Chest Physician (ACCP) guidelines [1•, 2•, 30]. Both were retrospective studies examining the indications for placement of both permanent and retrievable IVCFs [31,32]. As the SIR guidelines encompass more clinical scenarios in which a filter may be appropriate, it was not surprising that both studies found a higher rate of compliance with these guidelines as compared to the ACCP guidelines.…”

Section: Research In Indicationsmentioning

confidence: 99%

Inferior Vena Cava Filters: Indications, Outcomes, and Evidence

Montgomery

Kaufman

2015

Curr Treat Options Cardio Med

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Filter technology seems relatively stable, although absorbable devices are an area of investigational interest. The indications for filter placement remain controversial, with wide variations in adherence to guidelines, and relatively poor quality of data about the specific prophylactic indications of trauma or bariatric surgery. The outcomes of filters are not well-defined despite widespread clinical use, and good data remains difficult to obtain. Several larger database and institutional retrospective studies support the notions that while filters prevent pulmonary embolism, they may be associated with venous thrombotic complications. Some subsets of cancer patients may be at increased risk of these complications, but whether the filter or the underlying hypercoagulable state is the cause is not clear. Lastly, although the benefits of filter retrieval are widely assumed (but not proven), filter retrieval rates remain lower than expected. The single most influential factor in improving filter retrieval rates is dedicated follow-up with intent to retrieve the filter.

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Inferior Vena Cava Filters and Their Varying Compliance with the ACCP and the SIR Guidelines

Abstract: Compliance with the ACCP guidelines is poor in this series; however, much of the discrepancy is based on grade 2C evidence. Only grade 1 evidence will reconcile the differences between the two guidelines.

Cited by 8 publications

References 1 publication

ACR Appropriateness Criteria® Radiologic Management of Venous Thromboembolism-Inferior Vena Cava Filters

ACR Appropriateness Criteria® Radiologic Management of Venous Thromboembolism-Inferior Vena Cava Filters

The safety and validity of surgical resection for hemodialysis-dependent patients with renal cell carcinomas involving the inferior vena cava

Inferior Vena Cava Filters: Indications, Outcomes, and Evidence

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