Clinical evaluation of retrievable inferior vena cava filters for the prevention of pulmonary thromboembolism
Background and aims Inferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been increasingly used to prevent acute pulmonary thromboembolism (PTE) and allow retrieval upon reduction of PTE risk. However, the outcomes of their u...
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Published in | Heart and vessels Vol. 36; no. 11; pp. 1756 - 1764 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Tokyo
Springer Japan
01.11.2021
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
ISSN | 0910-8327 1615-2573 1615-2573 |
DOI | 10.1007/s00380-021-01856-5 |
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Abstract | Background and aims
Inferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been increasingly used to prevent acute pulmonary thromboembolism (PTE) and allow retrieval upon reduction of PTE risk. However, the outcomes of their use in Japan remain unknown.
Methods
This study retrospectively investigated the acute PTE relapse prevention rate, IVCF retrieval attempt rate, retrieval success rate, and long-term prognosis of 197 patients who underwent r-IVCF insertion at our hospital between 2010 and 2018.
Results
Subjects had a mean age of 68 years and a male-to-female ratio of 1:1. After r-IVCF insertion, the acute PTE prevention rate was 99.5%. The r-IVCF retrieval rate was 55% (108 patients), with a success rate of 99% (107 patients). r-IVCF retrieval was not attempted in 89 cases due to advanced cancer or poor prognosis (41%), loss to follow-up (32%), and long-term indwelling IVCF (17%). The retrieval group had an average observation period of 36 months, with their anticoagulation therapy continuation, PTE recurrence, and deep vein thrombosis (DVT) recurrence rates being 64%, 3%, and 4%, respectively. The non-retrieval group had a mean observation period of 21 months, with their anticoagulation continuation, PTE recurrence, and DVT recurrence rates being 78%, 3%, and 15%, respectively. DVT recurrence rates increased significantly in the non-retrieval group (
p
< 0.01). Moreover, 65% of all DVTs occurred centrally from the femoral veins, among which 9% were contraindicated for anticoagulation therapy.
Conclusions
IVCF placement significantly prevented acute PTE but promoted recurrent DVTs when not retrieved after risk reduction. Hence, to increase recovery rates, IVCFs be promptly removed when no longer necessary. |
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AbstractList | Inferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been increasingly used to prevent acute pulmonary thromboembolism (PTE) and allow retrieval upon reduction of PTE risk. However, the outcomes of their use in Japan remain unknown.BACKGROUND AND AIMSInferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been increasingly used to prevent acute pulmonary thromboembolism (PTE) and allow retrieval upon reduction of PTE risk. However, the outcomes of their use in Japan remain unknown.This study retrospectively investigated the acute PTE relapse prevention rate, IVCF retrieval attempt rate, retrieval success rate, and long-term prognosis of 197 patients who underwent r-IVCF insertion at our hospital between 2010 and 2018.METHODSThis study retrospectively investigated the acute PTE relapse prevention rate, IVCF retrieval attempt rate, retrieval success rate, and long-term prognosis of 197 patients who underwent r-IVCF insertion at our hospital between 2010 and 2018.Subjects had a mean age of 68 years and a male-to-female ratio of 1:1. After r-IVCF insertion, the acute PTE prevention rate was 99.5%. The r-IVCF retrieval rate was 55% (108 patients), with a success rate of 99% (107 patients). r-IVCF retrieval was not attempted in 89 cases due to advanced cancer or poor prognosis (41%), loss to follow-up (32%), and long-term indwelling IVCF (17%). The retrieval group had an average observation period of 36 months, with their anticoagulation therapy continuation, PTE recurrence, and deep vein thrombosis (DVT) recurrence rates being 64%, 3%, and 4%, respectively. The non-retrieval group had a mean observation period of 21 months, with their anticoagulation continuation, PTE recurrence, and DVT recurrence rates being 78%, 3%, and 15%, respectively. DVT recurrence rates increased significantly in the non-retrieval group (p < 0.01). Moreover, 65% of all DVTs occurred centrally from the femoral veins, among which 9% were contraindicated for anticoagulation therapy.RESULTSSubjects had a mean age of 68 years and a male-to-female ratio of 1:1. After r-IVCF insertion, the acute PTE prevention rate was 99.5%. The r-IVCF retrieval rate was 55% (108 patients), with a success rate of 99% (107 patients). r-IVCF retrieval was not attempted in 89 cases due to advanced cancer or poor prognosis (41%), loss to follow-up (32%), and long-term indwelling IVCF (17%). The retrieval group had an average observation period of 36 months, with their anticoagulation therapy continuation, PTE recurrence, and deep vein thrombosis (DVT) recurrence rates being 64%, 3%, and 4%, respectively. The non-retrieval group had a mean observation period of 21 months, with their anticoagulation continuation, PTE recurrence, and DVT recurrence rates being 78%, 3%, and 15%, respectively. DVT recurrence rates increased significantly in the non-retrieval group (p < 0.01). Moreover, 65% of all DVTs occurred centrally from the femoral veins, among which 9% were contraindicated for anticoagulation therapy.IVCF placement significantly prevented acute PTE but promoted recurrent DVTs when not retrieved after risk reduction. Hence, to increase recovery rates, IVCFs be promptly removed when no longer necessary.CONCLUSIONSIVCF placement significantly prevented acute PTE but promoted recurrent DVTs when not retrieved after risk reduction. Hence, to increase recovery rates, IVCFs be promptly removed when no longer necessary. Inferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been increasingly used to prevent acute pulmonary thromboembolism (PTE) and allow retrieval upon reduction of PTE risk. However, the outcomes of their use in Japan remain unknown. This study retrospectively investigated the acute PTE relapse prevention rate, IVCF retrieval attempt rate, retrieval success rate, and long-term prognosis of 197 patients who underwent r-IVCF insertion at our hospital between 2010 and 2018. Subjects had a mean age of 68 years and a male-to-female ratio of 1:1. After r-IVCF insertion, the acute PTE prevention rate was 99.5%. The r-IVCF retrieval rate was 55% (108 patients), with a success rate of 99% (107 patients). r-IVCF retrieval was not attempted in 89 cases due to advanced cancer or poor prognosis (41%), loss to follow-up (32%), and long-term indwelling IVCF (17%). The retrieval group had an average observation period of 36 months, with their anticoagulation therapy continuation, PTE recurrence, and deep vein thrombosis (DVT) recurrence rates being 64%, 3%, and 4%, respectively. The non-retrieval group had a mean observation period of 21 months, with their anticoagulation continuation, PTE recurrence, and DVT recurrence rates being 78%, 3%, and 15%, respectively. DVT recurrence rates increased significantly in the non-retrieval group (p < 0.01). Moreover, 65% of all DVTs occurred centrally from the femoral veins, among which 9% were contraindicated for anticoagulation therapy. IVCF placement significantly prevented acute PTE but promoted recurrent DVTs when not retrieved after risk reduction. Hence, to increase recovery rates, IVCFs be promptly removed when no longer necessary. Background and aims Inferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been increasingly used to prevent acute pulmonary thromboembolism (PTE) and allow retrieval upon reduction of PTE risk. However, the outcomes of their use in Japan remain unknown. Methods This study retrospectively investigated the acute PTE relapse prevention rate, IVCF retrieval attempt rate, retrieval success rate, and long-term prognosis of 197 patients who underwent r-IVCF insertion at our hospital between 2010 and 2018. Results Subjects had a mean age of 68 years and a male-to-female ratio of 1:1. After r-IVCF insertion, the acute PTE prevention rate was 99.5%. The r-IVCF retrieval rate was 55% (108 patients), with a success rate of 99% (107 patients). r-IVCF retrieval was not attempted in 89 cases due to advanced cancer or poor prognosis (41%), loss to follow-up (32%), and long-term indwelling IVCF (17%). The retrieval group had an average observation period of 36 months, with their anticoagulation therapy continuation, PTE recurrence, and deep vein thrombosis (DVT) recurrence rates being 64%, 3%, and 4%, respectively. The non-retrieval group had a mean observation period of 21 months, with their anticoagulation continuation, PTE recurrence, and DVT recurrence rates being 78%, 3%, and 15%, respectively. DVT recurrence rates increased significantly in the non-retrieval group ( p < 0.01). Moreover, 65% of all DVTs occurred centrally from the femoral veins, among which 9% were contraindicated for anticoagulation therapy. Conclusions IVCF placement significantly prevented acute PTE but promoted recurrent DVTs when not retrieved after risk reduction. Hence, to increase recovery rates, IVCFs be promptly removed when no longer necessary. Background and aimsInferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been increasingly used to prevent acute pulmonary thromboembolism (PTE) and allow retrieval upon reduction of PTE risk. However, the outcomes of their use in Japan remain unknown.MethodsThis study retrospectively investigated the acute PTE relapse prevention rate, IVCF retrieval attempt rate, retrieval success rate, and long-term prognosis of 197 patients who underwent r-IVCF insertion at our hospital between 2010 and 2018.ResultsSubjects had a mean age of 68 years and a male-to-female ratio of 1:1. After r-IVCF insertion, the acute PTE prevention rate was 99.5%. The r-IVCF retrieval rate was 55% (108 patients), with a success rate of 99% (107 patients). r-IVCF retrieval was not attempted in 89 cases due to advanced cancer or poor prognosis (41%), loss to follow-up (32%), and long-term indwelling IVCF (17%). The retrieval group had an average observation period of 36 months, with their anticoagulation therapy continuation, PTE recurrence, and deep vein thrombosis (DVT) recurrence rates being 64%, 3%, and 4%, respectively. The non-retrieval group had a mean observation period of 21 months, with their anticoagulation continuation, PTE recurrence, and DVT recurrence rates being 78%, 3%, and 15%, respectively. DVT recurrence rates increased significantly in the non-retrieval group (p < 0.01). Moreover, 65% of all DVTs occurred centrally from the femoral veins, among which 9% were contraindicated for anticoagulation therapy.ConclusionsIVCF placement significantly prevented acute PTE but promoted recurrent DVTs when not retrieved after risk reduction. Hence, to increase recovery rates, IVCFs be promptly removed when no longer necessary. |
Author | Nakamura, Shigeru Funatsu, Atsushi Hirano, Shojiro Ikeda, Takanori |
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CitedBy_id | crossref_primary_10_3389_fbioe_2022_1045220 crossref_primary_10_1007_s00380_024_02371_z crossref_primary_10_1016_j_avsg_2024_12_056 crossref_primary_10_1536_ihj_21_814 |
Cites_doi | 10.1161/CIRCULATIONAHA.104.512834 10.1016/j.jvs.2016.02.034 10.1016/j.jvir.2014.07.001 10.7134/phlebol.15-04 10.1111/j.1538-7836.2005.01448.x 10.1253/circj.68.816 10.1056/NEJM199802123380701 10.1148/radiol.12120372 10.1016/j.jcin.2013.03.006 10.2214/AJR.13.11097 10.1016/j.jvir.2011.08.024 |
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Keywords | Pulmonary embolism Deep vein thrombosis Inferior vena cava filter |
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Inferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been... Inferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been increasingly used to... Background and aimsInferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been... |
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SubjectTerms | Aged Anticoagulants Anticoagulants - therapeutic use Biomedical Engineering and Bioengineering Cardiac Surgery Cardiology Complications Device Removal Female Filters Humans Insertion Male Medicine Medicine & Public Health Original Article Patients Prevention Prognosis Pulmonary Embolism - etiology Pulmonary Embolism - prevention & control Pulmonary embolisms Retrieval Retrospective Studies Risk management Risk reduction Thromboembolism Thrombosis Treatment Outcome Vascular Surgery Vena Cava Filters Vena Cava, Inferior |
Title | Clinical evaluation of retrievable inferior vena cava filters for the prevention of pulmonary thromboembolism |
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