Improving the rate of inferior vena cava filter retrieval through multidisciplinary engagement.
Hannah Stevens; Hadley Bortz; Sharon Chao; Radha Ramanan; Warren Clements; Karlheinz Peter; James D McFadyen; Huyen Tran
Abstract
The placement of retrievable inferior vena cava (IVC) filters occurs commonly, but retrieval rates remain low. Consequently, there is an unmet clinical need to ensure appropriate follow-up and retrieval of these devices.To determine the association between an IVC filter surveillance team with filter retrievals or a documented filter plan, time to retrieval, and incidence of filter complications or recurrent venous thromboembolism.Ambidirectional cohort study evaluating consecutive IVC filter insertions before and after the implementation of a multidisciplinary surveillance team (MDST). We report an odds ratio (OR) with 95% CIs, adjusted by age, sex, weight, and malignancy status.Overall, 453 patients were included, with 272 individuals in the pre-MDST cohort and 181 individuals in the post-MDST cohort. The MDST was associated with a higher composite primary outcome of IVC filter retrieval or a documented filter plan from 79.4% in the pre-MDST cohort to 96.1% in the post-MDST cohort (OR, 6.44; 95% CI, 3.06-15.84) Compared with the pre-MDST cohort, IVC filter retrieval rates were higher in the post-MDST cohort (52.6%-73.5%, respectively; (OR, 2.50; 95% CI, 1.67-3.78). The MDST was associated with a shorter median time-to-filter retrieval (187-150 days, hazard ratio, 1.78; 95% CI, 1.39-2.29), but there was no significant difference when comparing symptomatic or clinically significant IVC filter complications, recurrent venous thromboembolism, or mortality..Our study demonstrates the importance of a structured program to ensure timely IVC filter retrieval and ultimately improve patient care.
Journal | RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS |
ISSN | 2475-0379 |
Published | 01 Jan 2023 |
Volume | 7 |
Issue | 1 |
Pages | 100040 100040 |
DOI | 10.1016/j.rpth.2023.100040 |
Type | Journal Article |
Sponsorship |