Ramin Hamidizadeh1, David Liu1,2, Faisal Khosa1,3, John Chung1,2, Darren Klass1,2, Behrang Homayoon1,4
1Faculty of Medicine, University of British Columbia, Vancouver, Canada
2Department of Radiology, Section of Interventional Radiology, Vancouver General Hospital, Vancouver, Canada
3Department of Radiology, Vancouver General Hospital, Vancouver, Canada
4Department of Radiology, Section of Interventional Radiology, Surrey Memorial Hospital, Surrey, Canada
Tóm tắt
Purpose To conduct a retrospective review and quality assurance study of inferior vena cava (IVC) filter retrieval over a two-year period at a tertiary care centre. Methods Patients who underwent IVC filter placement or retrieval over a two-year period were identified. Medical records were reviewed for patient characteristics, filter indication, time to filter retrieval, and complications. Results IVC filters were placed in 229 patients between January 1, 2015 and December 31, 2016. 113 retrievals were attempted and 101 filters were successfully retrieved (89.4%). Median time to first retrieval attempt was 48 days (range of 5–728). Seventy-one patients died in the interval after filter insertion before a retrieval attempt at a median time of 27 days (range of 3–430). In 17 patients, retrieval was complicated by or delayed because of penetration of IVC wall (n = 6), large thrombus burden trapped by filter (n = 5), filter tilt or migration (n = 3), and unclear reasons (n = 3). Time-to-first unsuccessful retrieval attempt was 141 days (median). Of all filters placed, 55.9% were never retrieved. Excluding deceased patients with in-situ filters (n = 71) and unsuccessful retrievals left in-situ as permanent filters (n = 5), there remains 52 patients (33%), with a median filter in-situ time of 488 days. Conclusion Our study indicates that as many as 33% of patients may have been lost to follow-up of their in-situ IVC filter. Considering widespread reports of long-term complications and the recent safety alert issued by Health Canada, it is evident that a unified strategy is needed to track patients post filter insertion.
