PURPOSE:To evaluate indications and outcomes of patients receiving an inferior vena cava (IVC) filter over a 3-year period.
METHODS:Chart reviews were performed on 373 consecutive patients (235 men and 138 women, mean age 54 ± 19years) who received an IVC filter. A classic indication for IVC filter placement was defined as high risk for VTE in the presence of a contraindication to anticoagulation, or failure of anticoagulation to prevent VTE. Absence of a classic indication is defined as tolerating prophylactic or full dosage anticoagulation at the time of IVC filter placement, or anticoagulation was started within the same day of IVC filter placement. Post-filter complications were recorded from 12 days after IVC filter placement to the last day of documented contact.
RESULTS:Of 373 patients, 237 (64%) receiving an IVC filter had a classic indication. Those patients with contraindications to anticoagulation include trauma (113), intracranial bleed (41), surgery (14), GI bleed (21), thrombocytopenia (12), and other causes (19). Of the 237 patients with a classic indication, 18 patients failed full dosage of anticoagulation. Of the 373 patients, 136 (36%) received an IVC filter without a classic indication. Ongoing or newly started prophylactic anticoagulation within the same day of IVC filter placement was administered to 71 patients. Full dosage anticoagulation was administered to 53 patients at the time of IVC filter placement.Follow-up of 294 patients was 258 ± 279 days. Of patients with a classic indication, 21 developed post-filter deep vein thrombosis (DVT), 2 developed PE, and 9 p had IVC filter thrombosis. Of patients without a classic indication, 8 developed post-filter DVT, and none developed PE.
CONCLUSION:We need to reevaluate use of IVC filters. Implementation of guidelines for IVC filter placement is needed to optimize clinical outcome for patients at risk for VTE.
CLINICAL IMPLICATIONS:We need to reevaluate use of IVC filters. Implementation of guidelines for IVC filter placement is needed to optimize clinical outcome for patients at risk for VTE.
DISCLOSURE:Parminder Singh, No Financial Disclosure Information; No Product/Research Disclosure Information