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Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort
Joshua D Brown1,2, Driss Raissi3, Qiong Han3
1Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY joshua.brown@ufl.edu.
Journal of the American Heart Association
|September 6, 2017
Summary
Retrieval of vena cava filters (VCFs) increased but remains low. Factors like age and comorbidities impact retrieval rates, which show a weak link to anticoagulation initiation.
Area of Science:
- Vascular surgery
- Interventional radiology
- Health services research
Background:
- Inferior Vena Cava Filters (IVCFs) are crucial for preventing pulmonary embolism.
- Complications associated with IVCFs escalate with prolonged dwell times.
- Timely retrieval of IVCFs is essential for patient safety.
Purpose of the Study:
- To evaluate IVCF retrieval rates within a national cohort.
- To identify patient demographics and clinical factors influencing IVCF retrieval.
- To examine the relationship between anticoagulation initiation and IVCF retrieval.
Main Methods:
- Utilized a national commercial administrative claims database to identify patients with IVCF placement.
- Classified indications for IVCF placement: pulmonary embolism (with/without DVT), DVT only, or prophylactic.
- Employed proportional hazard regression models to analyze associations with early (90-day) and 1-year IVCF retrieval.
Main Results:
- Out of 54,766 patients, 18.4% underwent IVCF retrieval within one year.
- IVCF retrieval rates increased from 14.0% in 2010 to approximately 24% in 2014.
- Older age, regional differences, and certain comorbidities were linked to lower retrieval rates.
Conclusions:
- IVCF retrieval rates have improved but remain suboptimal.
- Anticoagulation initiation demonstrated a weak correlation with IVCF retrieval.
- Longer anticoagulation exposure was observed in patients with non-retrieved IVCFs.
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