Utilization patterns with inferior vena cava filters: surgical versus percutaneous placement

Area of Science:

• Medical Imaging and Interventional Radiology
• Vascular Surgery
• Thromboembolic Disease Management

Background:

• Inferior vena cava (IVC) filters are used to prevent pulmonary embolism.
• Historically, surgical placement was common.
• The advent of percutaneous placement by interventional radiologists marked a shift in practice.

Purpose of the Study:

• To evaluate the change in IVC filter utilization following the introduction of interventional radiologic placement.
• To determine if expanded indications contributed to increased filter use.

Main Methods:

• Retrospective analysis of IVC filter placement data from 1986-1988 and 1990-1992.
• Comparison of placement methods (surgical vs. percutaneous), indications, and patient survival.
• Data collected from a single institution.

Main Results:

• Filter placement increased from 35 (1986-1988) to 201 (1990-1992).
• Percutaneous placement by radiologists became exclusive, replacing surgical methods.
• Indications for placement (contraindications to anticoagulation, complications, free-floating thrombus) remained largely unchanged, but utilization increased in severely ill patients.

Conclusions:

• Interventional radiologists now exclusively place IVC filters at this institution.
• Increased IVC filter utilization is attributed to broader use in high-risk, severely ill patients.
• While survival rates did not significantly improve, percutaneous placement may reduce hemorrhagic complications.