Purpose
The advent of retrievable IVC filters was practice changing1; Less than 10 years after their development reports were emerging in the literature that IVC filter use was increasing dramatically,2,3 that clinical use and indication was highly variable,4 and that the absence of appropriate follow-up was reflected in comparatively low retrieval rates.5 Concerns about these trends and emerging reports of complications from retained, retrievable filters prompted the FDA, CIRSE and BSIR, among others, to examine retrieval practices and take measures to improve filter care.6,7,8
[Fig 1]...
Methods and materials
Methods
A single centre retrospective analysis
Database analysed since the opening of the department in Oct 2014 until Aug 2021
Additional information acquired from electronic medical records and/or imaging systems where required
Total retrievals
Total insertions
Retrieval rate at our institution:Number of filters retrieved at our institution / number of filters inserted at our institution (minus permanent filters + deceased patients) * 100
Results
Results
178 IVC filters INSERTED at our institution from Oct 2014 - Aug 2021
[Fig 4]
Most common indication for filters inserted: PE with contraindication to anticoagulation
Of 178 filters inserted, 95 removed at the time of this review
95/178 retrievals = 53.4%
Controlling for deceased & permanent filters: 95/119 successful retrievals
79.8% retrieval rate for filters both inserted & removed at our institution
[Fig 6] [Fig 7]
200 total IVC filters RETRIVED at our institution from Oct 2014 - Aug 2021
[Fig 8]
200...
Conclusion
Conclusion
At 79.8%, retrieval rates for filters inserted at our institution are at the upper end of the spectrum presented in the literature6,7,13,14
We retrieve more filters than we place
Indication and clinical information regarding IVC filters is not always readily available
Physicians & Interventionalist alike should5 :
take an active role in review & evaluation of indications
contribute to appropriate follow-up & retrieval planning
Since the conclusion of this review, implementation of an IR fellow-led retrieval initiative saw:
Formal communication to the requesting teams...
References
1. Keeling A, Kinney T, Lee M. Optional inferior vena caval filters: where are we now?. European Radiology. 2008;18(8):1556-1568
2. Stein P, Matta F, Hull R. Increasing Use of Vena Cava Filters for Prevention of Pulmonary Embolism. The American Journal of Medicine. 2011;124(7):655-661.
3. Duszak R, Parker L, Levin D. Placement and Removal of Inferior Vena Cava Filters: National Trends in the Medicare Population. Journal of Vascular Surgery. 2012;55(1):293.
4. White R, Geraghty E, Brunson A, Murin S, Wun T, Spencer F et al. High...