A better inferior vena cava filter retrieval rate: A retrospective study in a single-center institution

Abstract

Purpose To determine practice patterns of inferior vena cava filters (IVCFs), retrieval rates, and reasons why retrievable-IVCFs (R-IVCFs) are kept permanent. Methods A total of 399 patients who received IVCFs at Third Hospital of Hebei Medical University from January 2017 to December 2017 were registered and retrospectively studied. Date of demographics, baseline medical history, dwell time, reasons why R-IVCFs were kept permanent, and R-IVCFs thrombus were collected. Results A total of 399 IVCFs were placed during the study period including 27 permanent IVCFs and 372 R-IVCFs. Among all patients who received R-IVCFs, the mean dwell time was 18.25 ± 16.60 days, follow-up rate was 96.24% (358/372), and 337 R-IVCFs were attempted to be removed. Except one, 336 R-IVCFs were retrieved successfully (336/372, 90.32%). Sixty-four R-IVCFs thrombi were found during retrieval including 53 small-size thrombi (< 1 cm × 1 cm) and 13 large-size thrombi (>1 cm × 1 cm). Fifty-three R-IVCFs with small-size thrombi were removed successfully with no additional treatments. Twelve large-size thrombi were retrieved successfully after catheter-directed thrombolysis. Conclusions With good follow-up, the retrieval rate could be improved to 90.32%. The main reasons why R-IVCFs were kept permanent were to avoid losing follow-up and overcome inappropriate selections of indications or IVCF types. And R-IVCFs with thrombus could be removed safely.

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

“…Others have found a substantial increase in retrieval rates (up to 90%) when certain follow-up strategies were implemented after filter placement. [19][20][21][22][23] These include use of multidisciplinary teams, standardized protocols, patient education, automated reminder, or referral systems and creation of dedicated VCF clinics. Such a standardized, structured follow-up program was not utilized at our institution during the study period, and despite limited data showing efficacy in increasing filter retrieval, a specific recommendation is not present in current guidelines.…”

“…Subsequent studies have reported that the incidence of these complications increases with prolonged use of filters 13 and a decision analysis study found that the risk/benefit profile favors filter removal between 29 and 54 days. 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.…”

Removing infrarenal inferior vena cava filters (IVCFs) with thrombus under protection of suprarenal IVCFs: A retrospective study in a single-center institution

“…Filter thrombus, usually discovered at the time of retrieval with an incidence ranged from 6 to 81%, [15][16][17][18][19][20][21] may not be associated with a worse prognosis, [20] but it still was a common cause of IVCF retrieval failure. IVCFs with small-size thrombus (<1*1cm) could be removed using regular techniques, [15,18,22] minimal study is available on filters with massive thrombus (>1*1cm) yet. Procedures of retrieval may be directly withdrawn as thrombus within filter were confirmed by venography in the past.…”

“…[7][8][9] Complications including filter fractures, penetration, migration, occlusions of inferior vena cava (IVC) has been emerged with the dramatic rise in permanent filter placement. [7,[9][10][11][12] Despite lots of efforts focused on improving retrieval rate in recent years, [13][14][15] some issues remain unresolved.…”

Retroperitoneal Laparoscopic-Assisted Retrieval of Wall-Penetrating Inferior Vena Cava Filter After Endovascular Techniques Failed: An Initial Clinical Outcome

“…The placement of the inferior vena cava (IVC) filter has been widely used in China to prevent pulmonary embolisms in patients with deep vein thrombosis (DVT), as it seems to be a safer choice than surgical plication or ligation and can be performed with minimal morbidity and mortality. 1 However, chronic indwelling IVC filters are associated with many potential risks, including penetration of the IVC, migration of the filter, infection, thrombotic events, and the potential need for lifelong anticoagulation. 2 IVC filters should be removed once the risk of pulmonary embolism has returned to baseline to prevent the significant morbidity associated with retained filters.…”