Prophylactic Inferior Vena Cava Filter Utilization and Risk Factors for Nonretrieval

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Cardiology

Background:

• Inferior vena cava filters (IVCFs) are frequently used prophylactically to prevent pulmonary embolism.
• Current practice patterns and retrieval rates for prophylactic IVCF placement require further definition.

Purpose of the Study:

• To define the indications for prophylactic IVCF placement.
• To determine the retrieval rate of prophylactic IVCFs.
• To identify risk factors associated with nonretrieval of prophylactic IVCFs.

Main Methods:

• Retrospective review of patients undergoing IVCF placement over a 2-year period.
• Analysis of a prospectively collected database for prophylactic IVCF placements.
• Multivariate logistic regression to identify risk factors for IVCF nonretrieval.

Main Results:

• Of 256 prophylactic IVCFs, 27.7% were retrieved, with a mean indwelling time of 92 days.
• Common indications included history of venous thromboembolic disease (43.7%), malignancy (35.1%), and bleeding risk (33.9%).
• Inpatients (32.4% retrieval) and preoperative patients were significantly less likely to have their IVCFs retrieved compared to outpatients (57.8% retrieval).

Conclusions:

• Prophylactic IVCF placement is common, but retrieval rates are low.
• Suboptimal usage of prophylactic IVCFs is suggested by the low retrieval rate.
• Interventions to increase IVCF retrieval are recommended, especially for inpatient and perioperative settings.