Retrievable versus permanent caval filter procedures: when are they cost-effective for interventional radiology?

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Health Economics

Background:

• Retrievable inferior vena cava (IVC) filters are often placed but not removed, leading to higher institutional costs compared to permanent filters (PFs).
• This practice offers no clinical benefit to patients and no additional revenue for healthcare providers.
• A cost-effective strategy for IVC filter placement is needed.

Purpose of the Study:

• To identify patient characteristics associated with the lack of removal of retrievable IVC filters (RFs).
• To develop a cost-effective strategy for RF placement.
• To analyze the financial implications of using RFs versus PFs.

Main Methods:

• A retrospective review of 160 consecutive IVC filter placements over 31 months.
• Identification of patient factors linked to non-removal of RFs.
• Calculation of cost savings if PFs were used instead of RFs in specific cases.

Main Results:

• Out of 160 filters, 118 were RFs, and only 23% were removed.
• Lack of RF removal was associated with patient age, ongoing malignancy, and the indication for placement.
• Applying specific selection criteria retrospectively could have saved $59,562 for the interventional radiology service.

Conclusions:

• Preferential use of RFs is financially beneficial only if removal rates exceed 41%.
• Implementing clinical criteria for device selection can lead to substantial cost savings.
• Optimizing IVC filter choice based on patient factors improves financial outcomes for IR units.