Placement of vena cava filters: factors affecting technical success and immediate complications.
OBJECTIVE
The goal of this study was to evaluate factors affecting technical success and the immediate complications of placement of vena cava filters.


METHODS
The medical records of 148 consecutive patients who underwent filter placement between December 1995 and February 1999 were retrospectively reviewed for cavography, technical success, complications, and operator specialty.


RESULTS
The records of 143 filter placements in 142 patients were complete (one patient underwent two placements). One hundred twenty filter placements were preceded by cavography, and 23 were not. Three misplacements (2.5%) were preceded by cavography and 10 (43%) were not (p<0.0001). One hundred fourteen filter placements were performed by radiologists and 29 by surgeons. Cavography was performed before 98% of placements by radiologists but in only 28% of placements by surgeons (p<0.0001). Filter misplacement occurred in 12 placements (41%) by surgeons and in only one (0.9%) by radiologists (p<0.0001). Major complications occurred in three placements (10%) by surgeons and in none of the placements by radiologists (p<0.01).


CONCLUSIONS
Vena cava filters were placed with greater technical success and fewer complications when preceded by cavography. Radiologists placed filters with greater technical success and fewer complications than surgeons, which may be the result of radiologists generally having more training and more familiarity with imaging-guided procedures and adhering more to cavography protocol. A credentialing requirement for physician operators and evaluation using quality improvement standards may be advisable.
Department of Radiology, St. Joseph Mercy - Oakland, 44405 Woodward Ave., Pontiac, MI 48341, USA.
Michael A
MA
Savin
Harish K
HK
Panicker
Shahzad
S
Sadiq
Yahya A
YA
Albeer
Ronald E
RE
Olson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence / Q000592:standards; D005260:Female; D013502:General Surgery; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008511:Medicine; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D011871:Radiology; D012189:Retrospective Studies; D013038:Specialization; D013923:Thromboembolism / Q000517:prevention & control*; D013997:Time Factors; D016306:Vena Cava Filters / Q000009:adverse effects* / Q000592:standards; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging* / Q000601:surgery*; D020246:Venous Thrombosis / Q000601:surgery*