Experience with vena cava filters at a large community hospital and level-I trauma center: Indications, complications, and compliance barriers

摘要

Introduction: Inferior vena cava filters (IVCF) are used liberally in clinical practice and have been associated with multiple complications. Herein, we present results from our institution. Methods: Records of consecutive patients discharged between January 1, 2009 and 2012 were reviewed. Indications were subcategorized under absolute, relative, and prophylactic. Student t test and Kaplan-Meier survival analysis were employed. Results: During this period, 254 vena cava filters (VCF) were placed. Of these, 65 were placed for absolute indication, 28 for relative, and 161 for prophylaxis. Follow-up imaging was available for 96 patients of which 15 showed complications. Successful retrieval of 19 filters was achieved. Conclusion: The study demonstrates that most IVCF are being placed for prophylaxis with low retrieval rate. This contradicts current recommendations. Moreover frequent migration and penetration of IVCF can lead to serious complications. Strict enforcement of IVCF placement guidelines and setting up of filter clinics for timely retrieval is suggested.