title: Placement and removal of inferior vena cava filters: national trends in the medicare population.
abstract: OBJECTIVE
  The aim of this study was to evaluate trends in the placement and removal of inferior vena cava (IVC) filters in the Medicare population.
  
  
  METHODS
  Summary Medicare claims data from 1999 through 2008 were used to identify the frequency of IVC filter placement procedures by specialty (radiology, surgery, cardiology, and all others) and site of service. Claims from 2003 (the first year the FDA cleared retrievable labeling for filters) through 2008 were used to identify intravascular foreign body retrieval procedures, and modeling was used estimate a frequency range of removal procedures. Trends over time were evaluated.
  
  
  RESULTS
  Between 1999 and 2008, total Medicare fee-for-service beneficiary frequency of IVC filter placement procedures increased by 111.5% (30,756 to 65,041). Volumes increased for radiologists (16,531 to 36,829 [+122.8%]), surgeons (11,295 to 22,606 [+100.1%]), and cardiologists (1,025 to 4,236 [+313.3%]). Relative specialty market shares changed little over time. Volumes increased by 114.2% (26,511 to 56,774) and 229.1% (2,286 to 7,524) for hospital inpatients and outpatients, respectively, and decreased by 62.1% (1,959 to 743) for those in all other locations combined. In 2008, with 65,041 filters placed, only an estimated 801 to 3,339 (1.2 to 5.1%) were removed.
  
  
  CONCLUSIONS
  The frequency of IVC filter placement has doubled over the past decade, and radiologists continue to perform more than half of all procedures. Although volume has more than tripled in hospital outpatients, the inpatient setting remains by far the most common site of service. In the Medicare population, IVC filters are not commonly removed.
authors: Mid-South Imaging and Therapeutics, Memphis, Tennessee, Memphis, Tennessee 38120, USA. rduszak@duszak.com
authors: Richard
authors: R
authors: Duszak
authors: Laurence
authors: L
authors: Parker
authors: David C
authors: DC
authors: Levin
authors: Vijay M
authors: VM
authors: Rao
mesh_terms: D020878:Device Removal / Q000639:trends*; D006801:Humans; D006278:Medicare / Q000639:trends*; D014481:United States; D016306:Vena Cava Filters / Q000639:trends*