Incidence of thrombotic events and complications associated to inferior vena cava filters in patients with and without anticoagulation therapy

Hinojosa, Carlos A.; Olivares-Cruz, Sandra; Laparra-Escareño, Hugo; Gómez-Arcive, Zeniff; Anaya‐Ayala, Javier E.

doi:10.24875/acme.m19000064

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…38,39 Early retrieval within 30 to 60 days of postplacement, as supported by others, 14 is an optimal strategy. An interesting observation, which was recently corroborated by others, 40 was that AC did not impact the rate of complications, suggesting that AC is not protective against thrombosis in patients with indwelling VCFs and retrieval should be prioritized.…”

Section: Discussionmentioning

confidence: 54%

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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Section: Discussionmentioning

confidence: 54%

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

Ionescu

Anusim

et al. 2021

TH Open

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“…[21][22][23] In our study, we observed a filter thrombus incidence of 10.1% in all patients receiving anticoagulation therapy, which may have accounted for this. In contrast, some studies 24,25 have shown that patients with IVCF on anticoagulation have equivalent rates of thrombotic events compared to patients without anticoagulation. Therefore, whether anticoagulants could significantly decrease the incidence of filter thrombi remains elusive.…”

Section: Discussionmentioning

confidence: 93%

Risk factors for inferior vena cava filter thrombosis in traumatic fracture patients with deep venous thrombosis of lower extremity: A single-center experience

et al. 2022

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Objective To explore the risk factors for inferior vena cava filter (IVCF) thrombus in orthopedic trauma patients who underwent filter placement with ongoing anticoagulation in clinical settings. Methods We retrospectively analyzed clinical data from fracture patients with lower extremity acute deep vein thrombosis (DVT) implanted with an IVCF admitted to Tianjin Hospital from January 2017 to December 2019. Potential risk factors, such as gender, age, diabetes, hypertension, fracture sites, thrombus location, free-floating thrombus, filter type, Injury Severity Score (ISS), and postoperative D-dimer values, were analyzed by the Chi-square test, t-test, logistic regression, and receiver operating characteristic (ROC) curve analysis. Results A total of 662 patients were included in our study, and filter-related thrombosis was present in 67 (10.1%) patients. No significant differences were observed in age, gender, hypertension, diabetes, fracture site, free-floating thrombus, filter type, indwelling time, and postoperative D-dimer level. Thrombus location and ISS were significantly different ( p < 0.05). Popliteal DVT (P-DVT) (odds ratio [OR]: 2.130, p = 0.018) and ISS (OR: 1.135, p = 0.000) were associated with filter thrombus. Patients with P-DVT were prone to a small filter thrombus (OR: 3.231, p = 0.037). From the ROC curve analysis, the diagnostic value of ISS was 24.5 and 26.5 for patients with filter and massive filter thrombus, respectively. Conclusion Thrombus location and ISS were independent risk factors for filter thrombus in patients with traumatic fractures. P-DVT had a higher potential to result in a small filter thrombus and an ISS value >26.5, which was considered a significant massive filter thrombus predictor.

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“…However, other studies have suggested that thrombosis in the filter is independent of anticoagulation. 32 We believe that thrombosis in IVCFs is associated with inadequate anticoagulation, thrombosis progression, and thrombus shedding in the acute phase of DVT. Most importantly, if we hypothesize that the thrombus in IVCFs has occurred from shedding in the acute phase of DVT, these patients might develop PE.…”

Section: Discussionmentioning

confidence: 96%

Retrievable inferior vena cava filter to prevent pulmonary embolism in patients with fractures and deep venous thrombosis of lower extremities: a single-center experience

et al. 2021

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Objective To evaluate the effectiveness of inserting a retrievable inferior vena cava filter (IVCF) to prevent pulmonary embolism (PE) in patients with bone fractures and acute deep venous thrombosis (DVT) before major orthopedic surgery. Methods Clinical data of patients with fractures and acute DVT who underwent IVCF insertion were analyzed. The patients were divided into above-knee DVT (AKDVT), popliteal vein thrombosis (PVT), and below-knee DVT (BKDVT) groups. Results An IVCF was successfully implanted in 964 patients, among whom 929 were followed up (335, 470, and 124 in AKDVT, PVT, and BKDVT groups, respectively). There was no significant difference in the incidence of filter thrombosis among the groups (11.04%, 11.70%, and 8.06%, respectively). No symptomatic PE occurred during follow-up. The mean filter indwelling time was 18.4 ± 4.3 days, and the total filter removal rate was 76.87%. There was no significant difference in the rate of filter implantation, retrieval, complications, or mortality among the groups. Conclusions Retrievable filters can effectively prevent PE before orthopedic surgery in patients with fractures and acute DVT of the lower limbs. AKDVT more readily forms a ≥1-cm thrombus in the IVCF than does BKDVT, and PVT more readily forms a <1-cm thrombus than does AKDVT.

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Incidence of thrombotic events and complications associated to inferior vena cava filters in patients with and without anticoagulation therapy

Abstract: Incidencia de eventos trombóticos y complicaciones asociadas al uso de filtros de vena cava en pacientes en pacientes con o sin terapia anticoagulante

Cited by 3 publications

References 25 publications

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

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

Risk factors for inferior vena cava filter thrombosis in traumatic fracture patients with deep venous thrombosis of lower extremity: A single-center experience

Retrievable inferior vena cava filter to prevent pulmonary embolism in patients with fractures and deep venous thrombosis of lower extremities: a single-center experience

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