Improving Inferior Vena Cava Filter Retrieval and Success Rates Using an Office Endovascular Center.

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Device Safety

Background:

• The FDA recommends inferior vena cava filter (IVCF) removal between 29-54 days post-insertion.
• National IVCF retrieval rates are low, approximately 23-25%.

Purpose of the Study:

• To evaluate the impact of a structured IVCF retrieval plan and access to an office endovascular center (OEC) on filter removal rates.
• To assess the safety and efficacy of IVCF removal procedures performed in an OEC.

Main Methods:

• Retrospective analysis of medical records for IVCF placement and removal by a single vascular surgery group (January 2011 - February 2017).
• Data abstracted included filter type, procedure site, retrieval plan, removal attempts, complications, success rates, and dwell time.
• Filters were removed under local anesthesia with or without mild sedation; anticoagulation was not interrupted.

Main Results:

• IVCF removal was attempted in 120 of 191 eligible patients; 71 were lost to follow-up, died, or had changed indications.
• For filters placed in the hospital (n=161), 62% were removed, with 86% of these attempts occurring in the OEC.
• In the OEC, 103 of 106 (97%) IVCF removals were successful, primarily via the jugular approach, with no mortality or bleeding complications.
• 40% of filters were removed after 3 months, indicating delayed retrieval.

Conclusions:

• A documented retrieval plan combined with OEC access enhances IVCF removal frequency compared to national averages.
• IVCF removal in an OEC setting is a safe and highly successful procedure.
• Continuing anticoagulation during IVCF retrieval does not increase bleeding risk.