Persistently low inferior vena cava filter retrieval rates in a population-based cohort

Invited Commentary.

Inferior Vena Cava Filter Placement and Retrieval Rates among Radiologists and Nonradiologists

1:57 PM Abstract No. 178 - Effectiveness and complications of routine and advanced inferior vena cava filter retrieval techniques

Reporting Standards for Inferior Vena Caval Filter Placement and Patient Follow-up: Supplement for Temporary and Retrievable/Optional Filters

Trends in inferior vena cava filter placement and retrieval at a tertiary care institution

Quality Improvement Guidelines for the Performance of Inferior Vena Cava Filter Placement for the Prevention of Pulmonary Embolism

Improving the retrieval rate of inferior vena cava filters with a multidisciplinary team approach

Rising Retrieval Rates of Inferior Vena Cava Filters in the United States: Insights From the 2012 to 2016 Summary Medicare Claims Data

Inferior vena cava (IVC) filters are placed to reduce venous thromboembolism (VTE)-related morbidity and mortality, though the evidence supporting this practice is limited. In 2010, the Food and Drug Administration (FDA) released a device safety advisory due to the risk of filter migration, fracture, and thrombosis with long-term use. The purpose of this study was to evaluate trends and predictors for IVCF placement and retrieval over a 10-year time period from a population health perspective. De-identified patient information from the State Inpatient Databases (SID) and the States Ambulatory Surgery and Services Databases (SASD) for Florida and California were used to identify all patients who underwent IVC filter placement from 2005 to 2014 and 2005 to 2011, respectively. Hospital practice patterns were assessed as a function of time as well as IVC filter placement and retrieval volume. Temporal trends were evaluated for statistical significance using the Cochran-Armitage test. A total of 181,260 IVC filters were placed in 178,327 patients over the study period. IVC filter placements peaked in 2010; following the FDA advisory in 2010, however, IVC filter placements monotonically decreased each subsequent year. The proportion of IVCF placement patients with both acute DVT and PE (17.6% vs 11.8%, P < 0.001) at the time of hospitalization increased; likewise, the proportion of IVCF patients with acute DVT or PE with a concomitant acute contraindication to anticoagulation at the time of hospitalization increased as well following 2010 (17.0% vs 11.9%, P < 0.001). From 2005 to 2014, there was a continual increase in both filter retrieval procedures as well overall percentage of filters retrieved. However, estimated retrieval rates remained low, with a retrieval rate of less than 6% in 2014. Following the FDA warning in 2010, there was a significant decrease in IVC filter placements, with filter placements more frequently performed in patients with poorer health. While retrieval rates increased over time, they remained low.

Characteristics of Inferior Vena Cava Filter Placement, Management, and Retrieval at a Multi-Center Institution

Few data exist regarding the rate of inferior vena cava (IVC) filter retrieval among brain-injured patients. We conducted a retrospective cohort study using inpatient claims between 2009 and 2015 from a nationally representative 5% sample of Medicare beneficiaries. We included patients aged ≥65 years who were hospitalized with acute brain injury. The primary outcome was the retrieval of IVC filter at 12 months and the secondary outcomes were the association with 30-day mortality and 12-month freedom from pulmonary embolism (PE). We used Current Procedural Terminology codes to ascertain filter placement and retrieval and International Classification of Diseases, Ninth Revision, Clinical Modification codes to ascertain venous thromboembolism (VTE) diagnoses. We used standard descriptive statistics to calculate the crude rate of filter placement. We used Cox proportional hazards analysis to examine the association between IVC filter placement and mortality and the occurrence of PE after adjustment for demographics, comorbidities, and mechanical ventilation. We used Kaplan-Meier survival statistics to calculate cumulative rates of retrieval 12 months after filter placement. Among 44 641 Medicare beneficiaries, 1068 (2.4%; 95% confidence interval [CI], 2.3%-2.5) received an IVC filter, of whom 452 (42.3%; 95% CI, 39.3%-45.3) had a diagnosis of VTE. After adjusting for demographics, comorbidities, and mechanical ventilation, filter placement was not associated with a reduced risk of mortality (hazard ratio [HR], 1.0; 95% CI, 0.8-1.3) regardless of documented VTE. The occurrence of pulmonary embolism at 12 months was associated with IVC filter placement (HR, 3.19; 95% CI, 1.3-3.3) in the most adjusted model. The cumulative rate of filter retrieval at 12 months was 4.4% (95% CI, 3.1%-6.1%); there was no significant difference in retrieval rates between those with and without VTE. In a large cohort of Medicare beneficiaries hospitalized with acute brain injury, IVC filter placement was uncommon, but once placed, very few filters were removed. IVC filter placement was not associated with a reduced risk of mortality and did not prevent future PE.

Inferior Vena Cava Filter (IVCF) Placement in a Community Hospital: Adherence to Guidelines, Retrieval Rates, and Complications

Permanent Inferior Vena Cava Filters Offer Greater Expected Patient Utility at Lower Predicted Cost

3:36 PM Abstract No. 286 Large-scale analysis of inferior vena cava filter placement and retrieval statistics over a 5-year period: evaluating trends and making predictions

Factors Associated With Inferior Vena Cava Filter Placement and Retrieval for Patients With Cancer-Associated Thrombosis