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Optimizing the management strategy for inferior vena cava filter.

Geoffroy Guillaubey1, Elie Ayoub2, Rémi Grange1

  • 1Department of Radiology, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France.

Quantitative Imaging in Medicine and Surgery
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Summary

Implementing a multidisciplinary (MD) approach significantly improves inferior vena cava filter (IVCF) retrieval rates. MD follow-up is more effective than simply notifying the general practitioner (GP) for IVCF removal.

Keywords:
Inferior vena cava filter retrieval (IVCF retrieval)deep vein thrombosis (DVT)optimizing patients’ managementpulmonary embolism (PE)

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Health Services Research

Background:

  • Complications associated with inferior vena cava filters (IVCFs) increase with prolonged dwell times.
  • Evaluating novel monitoring strategies is crucial for optimizing IVCF management and patient safety.
  • Previous practices lacked a structured multidisciplinary (MD) approach for IVCF follow-up.

Purpose of the Study:

  • To assess the efficacy of two new patient monitoring methods for IVCF retrieval.
  • To compare these novel methods against a non-multidisciplinary follow-up strategy.
  • To determine the impact of MD involvement on IVCF retrieval rates and complication occurrence.

Main Methods:

  • Retrospective analysis of IVCF retrieval rates across three distinct follow-up periods.
  • Period 1: Vascular medicine monitoring without MD input (April 2012 - Oct 2019).
  • Period 2: GP notification for specialist consultation (Nov 2019 - Oct 2021).
  • Period 3: MD discussion between radiology and vascular medicine (Nov 2021 - Nov 2023).
  • Systematic review of anticoagulant therapy contraindications, initial indications, and life expectancy in Period 3.

Main Results:

  • Overall IVCF retrieval rates increased from 40.5% (no specific follow-up) to 49.7% (MD meeting), though not significantly (P=0.15).
  • Adjusted retrieval rates improved significantly (P<0.001) from 62.9% (no specific follow-up) to 97.5% (MD meeting).
  • GP notification resulted in a moderate increase in adjusted retrieval rates (69.7%).

Conclusions:

  • Multidisciplinary (MD) involvement in patient follow-up significantly enhances the removal of unnecessary IVCFs.
  • While GP notification shows some effectiveness, MD follow-up demonstrates superior results in improving IVCF retrieval.
  • Optimizing IVCF management through structured MD collaboration is essential for reducing potential complications.