Jessica Ellen Panko MD, Presenter: Nothing to Disclose

Christopher S. Morris MD, Abstract Co-Author: Nothing to Disclose

This retrospective study evaluates the trends of vena cava filter placement and removal at our Level 1 trauma center over a 30 1/2 month period and compares it to an historical control group.

All procedures involving vena cava filter occurring between the 30 1/2 months from Jan. 1, 2003 to Jul. 15, 2005 were queried using hospital billing codes and verified against patient records. The trauma registry, interventional radiology database and patient charts were evaluated retrospectively. Patient demographics, filter type, location, indication, route of placement, complications, dwell time, repositioning, and removal were documented for every vena cava filter placed, repositioned or retrieved. All filter related procedures during this period are included in the study, even if the filter was placed prior to, or retrieved after the end of the study interval. Data was compared to a previous 15-month study interval from Dec. 2001-Feb. 2003.

290 filters were placed in 280 patients and 228 were retrievable (M=57% F=43%, 17-93 yrs old, mean 54.4 ± 19.4). 7 repositionings and 56 retrievals were performed. The retrieval rate is 19.3% of all filters or 24.6% of all optional filters placed. The mean dwell time was 54.0 ± 70.2 days: Bard Recovery, 87.7 days ± 83.3 (range 7-306), Gunther Tulip, 17.5 ± 7.8 (range 8-32) and OptEase, 15.2 ± 6.8 (range 5-30). The prior Gunther Tulip dwell time was 19 (range 11-41). Technical success rates have improved from 93% to 97.3%. Removal rate of 10.3% has improved to 19.3%. The technical success rate for removal was 98.2% and complication rate for removal was 0%. Placement complication rates have increased from 0% (0/136) to 3.1% (9/290). The rate of filter placement per month has increased from 9.07 (136 in 15 m) to 9.51 (290 in 30.5 m).

Due to a policy of diligent follow-up and the incorporation of new IVC filter designs, which can be left in place longer prior to removal, dwell times and retrieval rates have increased.

Prophylactic IVC filters, especially in young trauma patients are controversial due to complications. Dwell times and retrieval rates are better with diligent patient follow-up and new filter designs.

Panko, J, Morris, C, Increased Retrieval Rates and Dwell Times for Optional Inferior Vena Cava Filters at a Level I Trauma Center: Do Improved Patient Follow-up and New Inferior Vena Cava Filter Designs Make a Difference?.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4436544.html