Improving the rate of inferior vena cava filter retrieval through multidisciplinary engagement

Abstract

BackgroundThe placement of retrievable inferior vena cava (IVC) filters occurs commonly, but retrieval rates remain low. Consequently, there is an unmet clinical need to ensure appropriate follow-up and retrieval of these devices. ObjectivesTo determine the association between an IVC filter surveillance team with filter retrievals or a documented filter plan, time to retrieval, and incidence of filter complications or recurrent venous thromboembolism. MethodsAmbidirectional cohort study evaluating consecutive IVC filter insertions before and after the implementation of a multidisciplinary surveillance team (MDST). We report an odds ratio (OR) with 95% CIs, adjusted by age, sex, weight, and malignancy status. ResultsOverall, 453 patients were included, with 272 individuals in the pre-MDST cohort and 181 individuals in the post-MDST cohort. The MDST was associated with a higher composite primary outcome of IVC filter retrieval or a documented filter plan from 79.4% in the pre-MDST cohort to 96.1% in the post-MDST cohort (OR, 6.44; 95% CI, 3.06–15.84). Compared with the pre-MDST cohort, IVC filter retrieval rates were higher in the post-MDST cohort (52.6%–73.5%, respectively; (OR, 2.50; 95% CI, 1.67–3.78). The MDST was associated with a shorter median time-to-filter retrieval (187–150 days, hazard ratio, 1.78; 95% CI, 1.39–2.29), but there was no significant difference when comparing symptomatic or clinically significant IVC filter complications, recurrent venous thromboembolism, or mortality. ConclusionOur study demonstrates the importance of a structured program to ensure timely IVC filter retrieval and ultimately improve patient care.