Why optional inferior vena cava filters are not always retrieved? A real world 19 years experience in a Swiss tertiary care university hospital.

Buso, Giacomo; Alatri, Adriano; Calanca, Luca; Fresa, Marco; Qanadli, Salah D.; Pesavento, Raffaele; Mazzolai, Lucia

doi:10.1016/j.ejim.2020.01.025

Cited by 14 publications

(11 citation statements)

References 19 publications

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“…Several studies investigating factors associated with low IVCF retrieval rates have pointed out poor patient follow-up as the primary reason 10 . Utilization of IVCFs and the subsequent retrieval rates vary widely by geography Table 1.…”

Section: Discussionmentioning

confidence: 99%

Structured team-oriented program to follow patients after vena cava filter placement: a step forward in improving quality for filter retrieval

Qanadli

Rezaei‐Kalantari

Crivelli

et al. 2021

Sci Rep

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To reduce inferior vena cava filter (IVCF) related complications, retrieval is recommended whenever possible. Nevertheless, IVCF retrieval rates remain lower than expected, likely due to insufficient follow-up after placement. We evaluated the value of a structured program designed to follow patients by the interventional radiology team up to 5 months after IVCF placement. We prospectively enrolled 366 consecutive patients (mean age 64 ± 17 years; 201 men and 165 women) who benefited from IVCF between March 2015 and February 2020. The program consisted of advising the patient and clinicians to consider IVCF retrieval as soon as possible (standard workflow) and systematically planning an additional follow-up visit at 5-month. Clinical and technical eligibility, as well as technical success for retrieval (TSR) were evaluated. At 5-months, 38 (10.4%) patients were lost to follow-up, and 47 (12.8%) had died. Among survivors, the overall retrieval rate was 58%. The retrieval rates were 83% and 97% for the clinically eligible and technically eligible patients for retrieval, respectively. The 5-month visit enabled 89 additional retrievals (47.8%) compared to the standard workflow. No significant difference was seen in TSR before and after 5 months (p = 0.95). Improved patient tracking with a dedicated IVCF program results in an effective process to identify suitable patients for retrieval and drastically improves retrieval rates in eligible patients. Involving interventionalists in the process improved IVCF patient management.

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Section: Discussionmentioning

confidence: 99%

Structured team-oriented program to follow patients after vena cava filter placement: a step forward in improving quality for filter retrieval

Qanadli

Rezaei‐Kalantari

Crivelli

et al. 2021

Sci Rep

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“…14 Despite an increase in VCF retrieval in the United States following the 2010 FDA advisory statement [15][16][17][18] and several studies reporting retrieval rates of up to 85% following the implementation of structured follow-up programs, [19][20][21][22][23] at a national level, VCF retrieval rates remain low with an estimated average of 25 to 30% at 1 year. 13,16,18,24,25 European retrieval rates tend to be higher but vary from approximately 40 9,26 to 77% at 1 year. 27 Most available U.S. estimates used data prior to the second FDA warning (2014) and were based on national data which are prone to inherent bias (in-hospital data and coding bias) and lacked the granularity to assess the impact of demographic or clinical factors on retrieval rates.…”

Section: Introductionmentioning

confidence: 97%

Inferior Vena Cava Filter Retrieval Trends: A Single-Center Experience

Ionescu

Anusim

et al. 2021

TH Open

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Recognition of the adverse events of inferior vena cava filters (VCFs) has prompted the Food and Drug Administration (FDA) to issue safety warnings (2010 and 2014), advocating for removal, once the risk of pulmonary embolism has abated. Despite an initial increase in retrieval rates, these remain low (25–30% at 1 year in 2014). We retrospectively investigated retrieval trends in adults with VCFs placed between 2015 and 2018 at a single institution. The rate of retrievable VCF removal accounting for the competing risk of death was the main outcome. There were 494 VCFs placed (305 retrievable). The cumulative incidence of retrieval remained low (21% at 1 year), even after the second FDA warning (2014). Patients who resumed anticoagulation (AC) at any time were more likely to have retrieval (hazard ratio [HR] = 3.6, p < 0.01) and had higher retrieval rates at every time point (31.4 vs. 7.6% at 1 year). Advanced age (HR = 0.98 per year, p = 0.004), stroke (HR = 0.28, p = 0.028), and active malignancy (HR = 0.42, p = 0.006) predicted nonretrieval. Device-related complications were infrequent (<1%) but thrombotic complications occurred early and were more common for nonretrieved VCFs (17 vs. 12%, p = 0.29). Revision of guidelines to recommend active surveillance for the ability to tolerate AC in the immediate postimplantation period may improve retrieval rates.

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“…They found a generalized tendency of higher fracture rates and perforation for conical filters and higher IVC occlusion with those having a cylindrical or umbrella-like morphology. Furthermore, some filter types like Optease and TrapEase filters were more often left in place compared to others, partly due to higher filter thrombosis and VTE recurrence under anticoagulant therapy ( 30 , 31 ).…”

Section: Rationale For Filter Retrievalmentioning

confidence: 99%

“…On the other hand, certain situations preclude filter removal. These include patients' general condition like older age (>90 years), underlying disease (e.g., chronic renal failure), limited cardiopulmonary function and comorbidities (e.g., advanced malignancy, neurologic disorders), evidence of preoperative PE, anticoagulation failure after re-introduction, long-term contraindication of anticoagulation, and long-term immobilization and patient refusal ( 30 , 40 ). If the patient presented with at least one clinical criterion on the day of placement, the filter would be declared permanent, and the follow-up visit is canceled.…”

Section: Criteria For Filter Retrievalmentioning

confidence: 99%

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Vena Cava Filters: Toward Optimal Strategies for Filter Retrieval and Patients' Follow-Up

Rezaei‐Kalantari

Rotzinger

Qanadli

2022

Front. Cardiovasc. Med.

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Mortality rates associated with venous thromboembolism (VTE) are high. Inferior vena cava filters (IVCFs) have been frequently placed for these patients as part of their treatment, albeit the paucity of data showing their ultimate efficacy and potential risk of complications. Issues regarding long-term filter dwell time are accounted for in society guidelines. This topic has led to an FDA mandate for filter retrieved as soon as protection from pulmonary embolism is no longer needed. However, even though most are retrievable, some were inadvertently left as permanent, which carries an incremental lifetime risk to the patient. In the past decade, attempts have aimed to determine the optimal time interval during which filter needs to be removed. In addition, distinct strategies have been implemented to boost retrieval rates. This review discusses current conflicts in indications, the not uncommon complications, the rationale and need for timely retrieval, and different quality improvement strategies to fulfill this aim.

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Why optional inferior vena cava filters are not always retrieved? A real world 19 years experience in a Swiss tertiary care university hospital.

Cited by 14 publications

References 19 publications

Structured team-oriented program to follow patients after vena cava filter placement: a step forward in improving quality for filter retrieval

Structured team-oriented program to follow patients after vena cava filter placement: a step forward in improving quality for filter retrieval

Inferior Vena Cava Filter Retrieval Trends: A Single-Center Experience

Vena Cava Filters: Toward Optimal Strategies for Filter Retrieval and Patients' Follow-Up

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