Inferior vena cava filters utilization in patients with venous thromboembolism: Analysis of a database of a tertiary hospital

Abstract

Purpose The aim of the study was to assess the inferior vena cava filter (IVCF) utilization in patients with venous thromboembolism (VTE) in tertiary care. Methods We performed a retrospective analysis of database of a tertiary hospital in 2016–2017. All the records of patients admitted for VTE or diagnosed with VTE being hospitalized for other reasons were extracted. The data collected were number of patients, who received IVCF, indications to filter insertion, PE and death rate after procedure, frequency of IVCF occlusion. Results 2399 patients with VTE were admitted to hospital. 442 (18,4%) of them received IVCF (239 in 2016 and 203 in 2017). Retrievable models were used in most cases (98,8%). In 119 (5,0%) patients cava filters were used due to contraindications for anticoagulation, while in 184 (7,7%) patients’ anticoagulation was not effective and thrombosis progression was registered. 101 (4,2%) patients received IVCF due to high PE risk (length of floating thrombus ≥7 cm, in proximal location), high pulmonary hypertension was indication to IVCF insertion in 38 (1,6%) patients with deep vein thrombosis (DVT) in combination with pulmonary embolism (PE). Overall mortality rate after IVCF insertion was 5 (0,2%). No fatal PE was registered. IVCF occlusion during hospitalization occurred in 116 (4,8%) cases. Only 29 (1,2%) of patients were admitted back for IVCF removal. Conclusions Every one in five patients with proximal DVT and/or PE receives IVCF in a routine practice in tertiary hospital. The most common indications for IVCF implantation were inability for anticoagulation or anticoagulation failure. Removal rate of retrievable cava filters is low.

Oral Rivaroxaban Versus Warfarin After inferior Vena cava Filter Implantation: A Retrospective Cohort Study

“… 8 , 9 Among all patients with VTE, up to 20-40% in the USA and up to 20% in Russia undergoing IVC filter implantation. 10 - 12 Since retrievable filters were introduced several decades ago, their current removal rate is not high enough, estimated from 34% to 45%. 13 , 14 Thus, a lot of patients require anticoagulation in the presence of IVC filter, which raised concern about the reliability of direct oral anticoagulants (DOACs) in such circumstances.…”

Evaluation of hemodynamic effects of different inferior vena cava filter heads using computational fluid dynamics

“…Both DVT and PE are collectively referred to as venous thromboembolism (VTE) (Yamashita et al, 2022). Currently, systemic anticoagulation is still the preferred method of prevention for VTE OPEN ACCESS EDITED BY Yang Liu, Hong Kong Polytechnic University, Hong Kong SAR, China patients with underlying PE (Duffett and Carrier, 2017;Arslanbekov et al, 2021;Elias et al, 2021). Recent studies have shown that there is no additional benefit of IVCFs deployment in VTE patients with better anticoagulation therapy (Huang et al, 2021).…”