Temporary inferior vena cava filter indications, retrieval rates, and follow-up management at a multicenter tertiary care institution

Tao, Mary Jiayi; Montbriand, Janice; Eisenberg, Naomi; Sniderman, Kenneth W.; Roche-Nagle, Graham

doi:10.1016/j.jvs.2016.02.034

Cited by 39 publications

(24 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Procedural codes were utilized to identify VCF placement; however, these codes are not specific to permanent or retrievable devices. As of 2006, retrievable devices made up about 85% of the VCF market in the United States, which likely increased to >90% since then 38, 39, 40, 41. Therefore, the retrieval estimates presented here are underestimated.…”

Section: Discussionmentioning

confidence: 84%

“…As of 2006, retrievable devices made up about 85% of the VCF market in the United States, which likely increased to >90% since then. [38][39][40][41] Therefore, the retrieval estimates presented here are underestimated. Assuming that 10% to 20% of all VCFs used are permanent and thus cannot be retrieved, this would make our estimated retrieval 26% to 30%, making this corrected estimate near previous estimates of national retrieval rates of 30%.…”

Section: Limitationsmentioning

confidence: 86%

See 1 more Smart Citation

Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort

Brown

Raissi

Han

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundRetrieval of vena cava filters (VCFs) is important for safety as complications increase with longer dwell times. This study assessed VCF retrieval rates and factors associated with retrieval in a national cohort.Methods and Results VCFs were identified by procedural codes from an administrative claims database. Patients were identified who had a VCF placement during a hospitalization from a national commercial administrative claims database. Indications for VCF placement were identified as pulmonary embolism with or without deep vein thrombosis, deep vein thrombosis only, or prophylactic. Patient demographic and clinical characteristics were included in proportional hazard regression models to find associations with early (90‐day) and 1‐year VCF retrieval. Initiation of anticoagulation and the correlation between time‐to‐retrieval and time‐to‐initiation of anticoagulation were observed. Of 54 766 patients receiving a VCF, 36.9% had pulmonary embolism, 43.9% had deep vein thrombosis only, and 19.2% had no apparent venous thromboembolism present. Over the 1 year of follow‐up, the cumulative incidence of VCF retrieval was 18.4%. Retrieval increased over time from a low of 14.0% in 2010 up to ≈24% in 2014. In adjusted time‐to‐event models, increasing age, differing regions, and some comorbidities were associated with poorer retrieval rates. Initiation of anticoagulation was poorly correlated with retrieval, with anticoagulation preceding retrieval by a median of 51 days while those without retrieval had a median of 278 days of exposure to anticoagulation.Conclusions VCF retrieval increased over the study period but remained suboptimal and was weakly correlated with anticoagulation initiation.

show abstract

Section: Discussionmentioning

confidence: 84%

Section: Limitationsmentioning

confidence: 86%

Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort

Brown

Raissi

Han

et al. 2017

JAHA

View full text Add to dashboard Cite

show abstract

“…Failure to retrieve of IVC filter could be caused by several reasons including, patients being lost to follow-up, considerable thrombus within the filter, substantial filter tilt, embedded filter tip, embedded filter struts, strut perforation, and filter fracture. Multidisciplinary and systematic follow-up protocol, dedicated IVC filter clinic and proactive attitude previously shown to optimize filter retrieval rates in addition to optimization of resource allocation, and increased patient safety (6,7,35).…”

Section: Discussionmentioning

confidence: 99%

“…While the rate of filter implantation has more than doubled within the past several years, with a continuously increasing trend, the retrieval rates remain quite low, with a mean retrieval rate of 34%; figures as low as 8.5% are also reported. Thus the majority of retrievable IVC filters are not removed (4)(5)(6)(7). One prospective randomized trial…”

Section: Introductionmentioning

confidence: 99%

Inferior vena cava filter retrievals, standard and novel techniques

Kuyumcu¹,

Walker²

2016

Cardiovasc. Diagn. Ther.

View full text Add to dashboard Cite

Abstract:The placement of an inferior vena cava (IVC) filter is a well-established management strategy for patients with venous thromboembolism (VTE) disease in whom anticoagulant therapy is either contraindicated or has failed. IVC filters may also be placed for VTE prophylaxis in certain circumstances.There has been a tremendous growth in placement of retrievable IVC filters in the past decade yet the majority of the devices are not removed. Unretrieved IVC filters have several well-known complications that increase in frequency as the filter dwell time increases. These complications include caval wall penetration, filter fracture or migration, caval thrombosis and an increased risk for lower extremity deep vein thrombosis (DVT). Difficulty is sometimes encountered when attempting to retrieve indwelling filters, mainly because of either abnormal filter positioning or endothelization of filter components that are in contact with the IVC wall, thereby causing the filter to become embedded. The length of time that a filter remains indwelling also impacts the retrieval rate, as increased dwell times are associated with more difficult retrievals. Several techniques for difficult retrievals have been described in the medical literature. These techniques range from modifications of standard retrieval techniques to much more complex interventions. Complications related to complex retrievals are more common than those associated with standard retrieval techniques. The risks of complex filter retrievals should be compared with those of life-long anticoagulation associated with an unretrieved filter, and should be individualized. This article summarizes current techniques for IVC filter retrieval from a clinical point of view, with an emphasis on advanced retrieval techniques.

show abstract

“…56 Several studies have shown that dedicated, systematic follow-up programs improve both the rate and timeliness of filter retrieval, [57][58][59][60] with studies demonstrating a 6.7-to 14fold increase in retrieval rates following initiation of such a program. 61,62 Showcasing the importance of programs such as these has been the recent large increase in litigation related to complications resulting from IVC filters.…”

Section: Retrieval Rates Of Inferior Vena Cava Filtersmentioning

confidence: 99%

Inferior Vena Cava Filters: When to Place and When to Remove

Moriarty

Steinberger

2017

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Pulmonary embolism (PE) is a common and feared result of deep vein thrombosis. While anticoagulation is the mainstay of management, interruption of flow of thrombus from leg veins to the pulmonary circulation is frequently desired either in lieu of or in addition to anticoagulation. Inferior vena cava filters have become frequently used to prevent PE despite a paucity of evidence for efficacy and increasing concerns about the long-term complications of indwelling filters.

show abstract

Temporary inferior vena cava filter indications, retrieval rates, and follow-up management at a multicenter tertiary care institution

Abstract: Given the established complications relating to long indwelling times and recent Food and Drug Administration guidelines, a multidisciplinary and systematic follow-up protocol needs to be implemented to optimize filter retrieval rates and to ensure exemplary quality of care.

Cited by 39 publications

References 34 publications

Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort

Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort

Inferior vena cava filter retrievals, standard and novel techniques

Inferior Vena Cava Filters: When to Place and When to Remove

Contact Info

Product

Resources

About