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OBJECTIVES: Technological innovation has led to the development of inferior vena cava filters (IVCFs) that can be removed. After placement in individuals at high risk for venous thromboembolic disease, these filters may be removed after the period of increased risk has passed. This strategy may reduce the long-term incidence of adverse, filter-related sequalae. However, reported rates of filter retrieval are low. To better realize the potential benefits of IVCF retrieval, we recently initiated a standardized protocol for patients after placement of these devices. This report reviews our experience with this regimen.
METHODS: A standardized protocol, including an electronic database into which all patients undergoing IVCF insertion were entered, was instituted in October 2010. This database was reviewed at regular intervals to identify appropriate candidates for filter retrieval. The retrieval rate after institution of this regimen was compared to the rate in a historical control group. Additional data collected from the study group include: indication, device type, patient demographics, procedural details of placement and retrieval, and complications.
RESULTS: During the 34-month study period, retrievable IVCFs were placed in 124 patients. Our retrieval rate after initiation of a standardized protocol increased to 31% (38/124), compared to a rate of 13% (4/32) in the control group. In the study group, retrieval occured at a mean of 125 days after insertion and was performed without complication. IVCF retrieval was deemed inappropriate in 34 patients and two patients refused retrieval. Nine patients remain in active follow-up at study completion.
CONCLUSIONS: The introduction of a standardized protocol has increased our rate of IVCF retrieval.