Current status of the use of inferior vena cava filters in cases of pulmonary embolism in CCUs: From the Tokyo CCU Network.
OBJECTIVE
To elucidate the current status of use of inferior vena cava filters (IVCFs) in cases of pulmonary embolism at institutions belonging to the Tokyo CCU Network.


METHODS
We conducted a retrospective investigation of 832 consecutive cases of pulmonary embolism reported on survey forms to the Tokyo CCU Network between 2005 and 2010.


RESULTS
Of 832 cases of pulmonary embolism, IVCFs were used in 338 (40.6%) and not used in 415 (49.9%). Their use was unclear in 79 (9.5%) cases. The use rate gradually increased each year from 2005 until 2008 but decreased from 2009 onward. Moreover, 68.9% of the IVCFs used in cases were non-permanent types. In terms of pulmonary embolism severity, the rate of use was 37.2% in non-massive cases, 49.4% in sub-massive cases, 46.9% in massive cases, and 31.9% in collapse cases. Thirty-day mortality in cases of collapse in which IVCFs were not used was extremely high at 75.8%, suggesting that in many cases, rapid deterioration may occur with insufficient time for IVCF insertion. The differences in IVCF usage rate among institutions were large in the range of 12.5-90% from 2005 to 2008, which slightly declined to the range of 25.0-72.2% from 2009 to 2010.


CONCLUSIONS
We elucidated the current IVCF use status in cases of pulmonary embolism at institutions belonging to the Tokyo CCU Network. Since the status of use differed among institutions, future studies of effective methods of use are required.
Tokyo CCU Network Scientific Committee, Tokyo, Japan; Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan. Electronic address: y-tanabe@muj.biglobe.ne.jp.
Yasuhiro
Y
Tanabe
Tokyo CCU Network Scientific Committee, Tokyo, Japan.
Toru
T
Obayashi
Tokyo CCU Network Scientific Committee, Tokyo, Japan.
Takeshi
T
Yamamoto
Tokyo CCU Network Scientific Committee, Tokyo, Japan.
Jun
J
Nakata
Tokyo CCU Network Scientific Committee, Tokyo, Japan.
Hidenori
H
Yagi
Tokyo CCU Network Scientific Committee, Tokyo, Japan.
Morimasa
M
Takayama
Tokyo CCU Network Scientific Committee, Tokyo, Japan.
Ken
K
Nagao
D000368:Aged; D000369:Aged, 80 and over; D003325:Coronary Care Units / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014041:Tokyo / Q000453:epidemiology; D016306:Vena Cava Filters / Q000706:statistics & numerical data*
Deep vein thrombosis; Inferior vena cava filter; Pulmonary embolism