The purpose of this study is to evaluate retrievable inferior vena cava (IVC) filters in terms of outcome, complications according to whether anticoagulants were administered, rate of retrieval, and success of retrieval in relation to duration of insertion.
Records of 144 patients with retrievable IVC filters inserted between January 2004 to September 2008 at a community/teaching hospital were reviewed. The records were assessed to determine efficacy, complications, duration of insertion, and number of attempts at retrieval.
Non-bleeding complications of IVC filters occurred in 20 of 144 (14%) patients. The incidence of thrombotic complications (new deep venous thrombosis, pulmonary embolism, IVC thrombosis, or postphlebitic syndrome) was similar in those who received anticoagulants for the entire duration of IVC filter insertion, 8 of 62 (13%) and those who did not receive anticoagulants 7 of 47 (15%). Among those who received anticoagulants for the full duration of insertion, major bleeding occurred in 4 of 62 (6%), one of which was fatal. Retrieval of IVC filters was attempted in 14 of 144 (10%) patients at 4.6 ± 2.1 months (mean + standard deviation) after insertion. Retrieval was successful in 10 of 144 (7%). Unsuccessful attempts at retrieval were at 3, 6, 8 and 9 months after insertion.
In conclusion, retrieval was attempted in only a minority of patients. Although the proportion of IVC filters that can be safely retrieved is inversely related to the duration of insertion, it is often possible to retrieve IVC filters as long as 6 months after insertion. Thrombotic complications of retrievable IVC filters were not prevented by anticoagulants.
The timely retrieval of IVC filter, may offer a risk reduction of pulmonary embolism without the long-term complications associated with permanent IVC filters.
Fahad Younas, No Financial Disclosure Information; No Product/Research Disclosure Information