A Systematic Method for Follow-Up Improves Removal Rates for Retrievable Inferior Vena Cava Filters in a Trauma Patient Population

Abstract

A dedicated system for following-up patients with rIVCFs markedly improves removal rates of retrievable filters.

Improving retrieval rates of temporary inferior vena cava filters

“…Few papers have reported the technical failure of filter retrieval ranging from 3.5 to 25.8%. 13,14,[22][23][24][25][26][27][28] In our series, the technical failure rate was 14%. Reported reasons for failure to retrieve have been prolonged indwelling time leading to cava wall adherence, severe tilting of the filter, and thrombus within the filter.…”

“…[8][9][10][11][12] There was improvement of IVC retrieval from 60% to 86% in centers that adopted systematic approach after noticing their low retrieval rate. [13][14][15] Other than questioning the insertion of IVCF for prophylaxis, the complication rate at short-term and long-term is another problem. Therefore, the hypothesis of our study was to investigate whether having an IVCF program in place would improve retrieval rates in comparison to our historical institutional data and that of the literature.…”

Improving the retrieval rate of inferior vena cava filters with a multidisciplinary team approach

“…Whereas the overall evidence linking the establishment of a dedicated patient tracking and outreach program and its favorable effect on the retrieval rate of IVC filter is strong, these previous studies were limited by the single disciplinary nature of the program, 15,16,22,24–26 the inclusion of study subjects restricted to trauma patients, 21,22,25–27 and the placement of IVC filters by a single department. 15,16,23,24 To overcome these limitations, the IVC filter retrieval protocol presented in our study was designed and implemented through a multidisciplinary team approach, with all parties invested in improving the tracking of these filters.…”

“…15,16,23,24 To overcome these limitations, the IVC filter retrieval protocol presented in our study was designed and implemented through a multidisciplinary team approach, with all parties invested in improving the tracking of these filters. Unlike in prior studies, in which a single department assumed the sole responsibility for ensuring timely follow-up evaluations and filter retrievals, 15,16,22,24–26 the vascular surgery coordinator provided follow-up reminders to all procedural services—vascular surgery, interventional radiology, and cardiology—and in response, each individual department coordinated scheduling of appointments and retrievals with their respective patients to maximize the likelihood for successful filter retrieval, as previously described by Karmy-Jones et al 28 More important, the study subjects evaluated in the present study were not just limited to trauma patients 21,22,25–27 or patients with IVC filters placed by a single department, 15,16,23,24 but rather we included all patients with retrievable IVC filters inserted at our institution. Such individuals are highly representative of the population of patients seen by many urban tertiary academic medical centers in the country.…”

Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large U.S Cohort

“…[29][30][31][32][33] Patient follow-up is generally left to the referring or primary physician, with some studies showing improved retrieval if the responsibility of follow-up is placed on the implanting physician instead. [32][33][34] In institutions where the implanting physicians are made responsible for patient follow-up, retrieval rates have increased from 24% to 59% and 29% to 60%.…”