title: Indications, complications, and management of inferior vena cava filters: the experience in 952 patients at an academic hospital with a level I trauma center.
abstract: OBJECTIVE
  Retrievable inferior vena cava (IVC) filters were designed to provide temporary protection from pulmonary embolism, sparing patients from long-term complications of permanent filters. However, many retrievable IVC filters are left in place indefinitely.
  
  
  OBJECTIVE
  To review the medical records of patients with IVC filters to determine patient demographics and date of and indication for IVC filter placement, as well as complications, follow-up data, date of IVC filter retrieval, and use of anticoagulant therapy.
  
  
  METHODS
  A retrospective review of IVC filter use between August 1, 2003, and February 28, 2011, was conducted at Boston Medical Center, a tertiary referral center with the largest trauma center in New England.
  
  
  METHODS
  In total, 978 patients. Twenty six patients were excluded from the study because of incomplete medical records.
  
  
  METHODS
  Placement of retrievable IVC filter.
  
  
  METHODS
  In total, 952 medical records were included in the analysis.
  
  
  RESULTS
  Of 679 retrievable IVC filters that were placed, 58 (8.5%) were successfully removed. Unsuccessful retrieval attempts were made in 13 patients (18.3% of attempts). Seventy-four venous thrombotic events (7.8% of 952 patients included in the study) occurred after IVC filter placement, including 25 pulmonary emboli, all of which occurred with the IVC filter in place. Forty-eight percent of venous thrombotic events were in patients without venous thromboembolism at the time of IVC filter placement, and 89.4% occurred in patients not receiving anticoagulants. Many IVC filters placed after trauma were inserted when the highest bleeding risk had subsided, and anticoagulant therapy may have been appropriate. While many of these filters were placed because of a perceived contraindication to anticoagulants, 237 patients (24.9%) were discharged on a regimen of anticoagulant therapy.
  
  
  CONCLUSIONS
  Our research suggests that the use of IVC filters for prophylaxis and treatment of venous thrombotic events, combined with a low retrieval rate and inconsistent use of anticoagulant therapy, results in suboptimal outcomes due to high rates of venous thromboembolism.
authors.affiliation: Section of Hematology and Oncology, Department of Medicine, Boston University, Boston, MA 02118, USA. shayna.sarosiek@bmc.org
authors.forename: Shayna
authors.initials: S
authors.lastname: Sarosiek
authors.forename: Mark
authors.initials: M
authors.lastname: Crowther
authors.forename: J Mark
authors.initials: JM
authors.lastname: Sloan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000517:prevention & control; D012189:Retrospective Studies; D016306:Vena Cava Filters / Q000009:adverse effects; D054556:Venous Thromboembolism / Q000628:therapy
chemical_list: D000925:Anticoagulants