Removable Inferior Vena Cava Filters and Vena Cava Thrombosis

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Kenneth J. Sauve, BS, Juan Ayerdi, MD, Matthew S. Edwards, MD, Jeanette M. Stafford, MS, Brandon L. Craven, BS, Randolph L. Geary, MD, George W. Plonk, MD, Kim J. Hodgson, MD, Robert B. McLafferty, MD, Kimberley J. Hansen, MD.
Wake Forest University, Winston-Salem, NC, USA.

Objectives: Retrievable inferior vena cava filters (R-IVCF) are a new and exciting addition to the therapeutic armamentarium for pulmonary embolus prevention. However, limited data exist regarding complication rates with regards to inferior vena cava (IVC) thrombosis.
Methods: Records from patients undergoing IVC filter placement at our institution between January 2000 and December 2004 were reviewed. Data collected included demographics, anthropometrics, procedural specifics, filter type, procedure indication, and complications. Continuous and categorical data were analyzed using t-test, chi-square, and Fisher’s exact testing as appropriate.
Results: 239 IVC filters were placed, including 213 permanent filters (P-IVCF) and 26 R-IVCF. The study group consisted of 148 males (62%), 91 females (38%), 201 Caucasians (84%), 34 African-Americans (14%), and 4 Hispanic (2%) individuals with a mean age of 53 years. IVC thrombosis occurred in 6 of 239 patients (2.5%), including 5 males and 1 female with a mean age of 54 years. Mean time from IVC filter placement to thrombosis was 155 ± 325 days (median=23 days). Filter type and rate of thrombosis are presented in Table 1 below. A significantly higher rate of IVC thrombosis was observed among patients treated with R-IVCF (0.9% vs.15.4%, P=0.0014).
Conclusions: In this single-center experience, the use of R-IVC filters was associated with a significantly higher rate of IVC thrombosis following implantation. These findings are concerning and merit further investigation.
Table 1