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CC BY 4.0 · TH Open 2021; 05(01): e73-e80
DOI: 10.1055/s-0040-1722707
Original Article

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

Filip Ionescu 
1   Department of Internal Medicine, Beaumont Health System, Royal Oak, Michigan, United States
,
Nwabundo Anusim
2   Department of Hematology-Oncology, Beaumont Health System, Royal Oak, Michigan, United States
,
Eva Ma
1   Department of Internal Medicine, Beaumont Health System, Royal Oak, Michigan, United States
,
Lihua Qu
3   Beaumont Health Research Institute, Royal Oak, Michigan, United States
,
LeAnn M. Blankenship
2   Department of Hematology-Oncology, Beaumont Health System, Royal Oak, Michigan, United States
,
Michael Stender
2   Department of Hematology-Oncology, Beaumont Health System, Royal Oak, Michigan, United States
,
Ishmael Jaiyesimi
2   Department of Hematology-Oncology, Beaumont Health System, Royal Oak, Michigan, United States
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Abstract

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.

Keywords

IVC filter - retrieval - thrombosis - filter failure - practice trends

Authors' Contributions

All authors contributed to data collection, analysis, and manuscript revision. F.I. and N.A. contributed equally as cofirst authors to the design of the study, data analysis, and manuscript preparation. All authors approved the final version.




Publication History

Received: 30 March 2020

Accepted: 10 December 2020

Article published online:
10 February 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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