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CC BY-NC-ND 4.0 · TH Open 2025; 09: a27315430
DOI: 10.1055/a-2731-5430
Original Article

Trends and Predictors of Vena Cava Filter Use (2004–2023): A Swiss Nationwide Epidemiological Study

Autoren

  • Simon Wolf 

    1   Department of Angiology, University Hospital Zurich, Zurich, Switzerland
    2   University of Zurich, Zurich, Switzerland
    1   Department of Angiology, University Hospital Zurich, Zurich, Switzerland

  • Pilar Müller

    1   Department of Angiology, University Hospital Zurich, Zurich, Switzerland
    2   University of Zurich, Zurich, Switzerland
    1   Department of Angiology, University Hospital Zurich, Zurich, Switzerland

  • Silvia Cardi

    1   Department of Angiology, University Hospital Zurich, Zurich, Switzerland
    3   Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy

  • Behnood Bikdeli

    4   Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
    5   Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
    6   YNHH/Yale Center for Outcomes Research and Evaluation (CORE), New Haven, Connecticut, United States

  • Lukas Hobohm

    7   Center for Thrombosis and Hemostasis, University Hospital of the Johannes Gutenberg University Mainz, Mainz, Germany
    8   Kardiologie I, Zentrum für Kardiologie, University Hospital of the Johannes Gutenberg University Mainz, Mainz, Germany

  • Karsten Keller

    7   Center for Thrombosis and Hemostasis, University Hospital of the Johannes Gutenberg University Mainz, Mainz, Germany
    8   Kardiologie I, Zentrum für Kardiologie, University Hospital of the Johannes Gutenberg University Mainz, Mainz, Germany

  • Nils Kucher

    1   Department of Angiology, University Hospital Zurich, Zurich, Switzerland
    2   University of Zurich, Zurich, Switzerland

  • Stefano Barco 

    1   Department of Angiology, University Hospital Zurich, Zurich, Switzerland
    2   University of Zurich, Zurich, Switzerland
    7   Center for Thrombosis and Hemostasis, University Hospital of the Johannes Gutenberg University Mainz, Mainz, Germany
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Abstract

Background

Recent data on inferior vena cava filter (IVCF) placement mainly originate from the United States, with limited evidence from Europe.

Methods

We used nationwide, patient-level data from 2004 to 2023, including hospitalizations with mention of IVCF placement or venous thromboembolism (VTE). Placement was classified as secondary prevention if VTE was documented during the hospitalization, otherwise as primary prevention. We assessed IVCF placement rates overall and in patients with pulmonary embolism (PE), and studied in-hospital case fatality rates, retrieval rates, and length of hospitalization. Analyses were stratified by prevention type and sex.

Results

IVCF placement was recorded in 5,123 (81.1% secondary prevention) patients. The age-standardized rate of IVCF placement increased from 3.4 (95% confidence interval [CI]: 2.0; 4.8) per 1,000 PE-related hospitalizations in 2004 to 19.2 (95% CI: 16.7; 21.6) per 1,000 PE-related hospitalizations in 2023. The IVCF-related in-hospital case fatality rate increased from 7.1% (95% CI: 1.1; 13.2) in 2004 to 10.2% (95% CI: 7.2; 13.3) in 2023 and was higher after IVCF placement for secondary prevention than for primary prevention. The estimated retrieval rate within an average of 6 months was 31.9% (95% CI: 29.9; 34.0), peaking at 34.6% (95% CI: 32.4; 36.8) after excluding deaths during index hospitalization. The retrieval rate decreased progressively over time. IVCFs were less likely to be retrieved among older patients and in patients with intracranial hemorrhage or cancer, whereas the removal rate was higher among patients with recent trauma.

Conclusion

We showed an increasing trend of IVCF placement procedures. The IVCF retrieval rate decreased over time, emphasizing the need for improved follow-up protocols.

Keywords

inferior vena cava filter - venous thromboembolism - retrieval

Authors' Contributions

P.M. and S.B. contributed to the concept and design of the study, interpretation of the results, writing of the manuscript, and final approval of the article. S.W. contributed the concept and design of the study, statistical analysis, interpretation of the results, writing of the manuscript, and final approval of the article. S.C., B.B., L.H., K.K., and N.K. contributed to the interpretation of the results, critical revision of the manuscript, and final approval of the article.


Data Availability Statement

Statistical source code used to generate population estimates and calculation of rates can be obtained from the study statistician (S.W., email: simon.wolf@usz.ch). The Swiss Medical Statistics can be purchased from the Swiss Federal Statistics Office. Demographic data can be downloaded from the webpage of the Swiss Federal Statistics Office.


* These authors share co-first authorship for this article.


Supplementary Material



Publikationsverlauf

Eingereicht: 04. September 2025

Angenommen: 11. September 2025

Artikel online veröffentlicht:
25. November 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Simon Wolf, Pilar Müller, Silvia Cardi, Behnood Bikdeli, Lukas Hobohm, Karsten Keller, Nils Kucher, Stefano Barco. Trends and Predictors of Vena Cava Filter Use (2004–2023): A Swiss Nationwide Epidemiological Study. TH Open 2025; 09: a27315430.
DOI: 10.1055/a-2731-5430
 

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