Institutional protocol improves retrievable inferior vena cava filter recovery rate.
BACKGROUND
In the trauma population, the use of retrievable inferior vena cava filters (RIVCF) is rapidly gaining acceptance in patients at high risk for venous thromboembolism. This study reports the impact of an institutional protocol on retrieval rates of RIVCF at a level I trauma center.


METHODS
A review of an institutional Trauma Registry identified 94 consecutive patients who received RIVCF between January 2004 and February 2007 (group I) before the protocol was instituted. Under the protocol, 61 consecutive trauma patients received RIVCF between August 2007 and July 2008 (group II) and were prospectively followed.


RESULTS
Filter retrieval eligibility criteria were met in 81% (76/94) of patients in group I and in 61% (37/61) of patients in group II. Of those eligible, retrieval-attempt rates were 42% (32/76) in group I versus 95% (35/37) in group II (P < .001). Clinician oversight of the filter accounted for 89% (39/44) of failure of retrieval attempts; patient noncompliance accounted for the rest in group I. In group II, the latter accounted for all such failures. Retrieval was successful in 37% (28/76) and in 84% (31/37) of the eligible patients in groups I and II, respectively (P < .001). No retrieval procedure-related complications occurred.


CONCLUSIONS
An institutional protocol for prospective monitoring of RIVCF significantly increases filter retrieval rate.
Ko
Sae Hee
SH
Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Reynolds
Benjamin R
BR
Nicholas
Deidra H
DH
Zenati
Mazen
M
Alarcon
Louis
L
Dillavou
Ellen D
ED
Chaer
Rabih
R
Peitzman
Andrew B
AB
Cho
Jae-Sung
JS
D000328:Adult; D000368:Aged; D020878:Device Removal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000517:prevention & control*; D016306:Vena Cava Filters; D054556:Venous Thromboembolism / Q000517:prevention & control*