Inferior Vena Cava Filter Retrieval Trends: A Single-Center Experience
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 lo...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2021-01-01
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| Series: | TH Open |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1722707 |
| _version_ | 1819160305427546112 |
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| author | Filip Ionescu Nwabundo Anusim Eva Ma Lihua Qu LeAnn M. Blankenship Michael Stender Ishmael Jaiyesimi |
| author_facet | Filip Ionescu Nwabundo Anusim Eva Ma Lihua Qu LeAnn M. Blankenship Michael Stender Ishmael Jaiyesimi |
| author_sort | Filip Ionescu |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T16:54:20Z |
| format | Article |
| id | doaj.art-77903afd6bbb470f8e538e689ebd9c5f |
| institution | Directory Open Access Journal |
| issn | 2512-9465 |
| language | English |
| last_indexed | 2024-12-22T16:54:20Z |
| publishDate | 2021-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | TH Open |
| spelling | doaj.art-77903afd6bbb470f8e538e689ebd9c5f2022-12-21T18:19:29ZengGeorg Thieme Verlag KGTH Open2512-94652021-01-010501e73e8010.1055/s-0040-1722707Inferior Vena Cava Filter Retrieval Trends: A Single-Center ExperienceFilip Ionescu0Nwabundo Anusim1Eva Ma2Lihua Qu3LeAnn M. Blankenship4Michael Stender5Ishmael Jaiyesimi6Department of Internal Medicine, Beaumont Health System, Royal Oak, Michigan, United StatesDepartment of Hematology-Oncology, Beaumont Health System, Royal Oak, Michigan, United StatesDepartment of Internal Medicine, Beaumont Health System, Royal Oak, Michigan, United StatesBeaumont Health Research Institute, Royal Oak, Michigan, United StatesDepartment of Hematology-Oncology, Beaumont Health System, Royal Oak, Michigan, United StatesDepartment of Hematology-Oncology, Beaumont Health System, Royal Oak, Michigan, United StatesDepartment of Hematology-Oncology, Beaumont Health System, Royal Oak, Michigan, United StatesRecognition 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.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1722707ivc filterretrievalthrombosisfilter failurepractice trends |
| spellingShingle | Filip Ionescu Nwabundo Anusim Eva Ma Lihua Qu LeAnn M. Blankenship Michael Stender Ishmael Jaiyesimi Inferior Vena Cava Filter Retrieval Trends: A Single-Center Experience TH Open ivc filter retrieval thrombosis filter failure practice trends |
| title | Inferior Vena Cava Filter Retrieval Trends: A Single-Center Experience |
| title_full | Inferior Vena Cava Filter Retrieval Trends: A Single-Center Experience |
| title_fullStr | Inferior Vena Cava Filter Retrieval Trends: A Single-Center Experience |
| title_full_unstemmed | Inferior Vena Cava Filter Retrieval Trends: A Single-Center Experience |
| title_short | Inferior Vena Cava Filter Retrieval Trends: A Single-Center Experience |
| title_sort | inferior vena cava filter retrieval trends a single center experience |
| topic | ivc filter retrieval thrombosis filter failure practice trends |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1722707 |
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