title: Predictors of attempted inferior vena cava filters retrieval in a tertiary care centre.
abstract: BACKGROUND
  Retrieval rates of optional recovery inferior vena cava (IVC) filters in US hospitals range from 11 - 70%. We conducted a retrospective study in a Canadian tertiary care centre to determine retrieval rates and predictors of filter removal.
  
  
  METHODS
  Consecutive patients who had a retrievable IVC filter inserted or removed between January 2007 and December 2010 were identified. Data collected included baseline demographics, indications for filter insertion and removal, documentation of an IVC filter management plan, reasons for non-retrieval, complications, and death.
  
  
  RESULTS
  275 patients with a median age of 60years were followed in hospital for a median of 17 patient-days (range 1-876). Indications for filter placement were acute or prior VTE with contraindication to anticoagulation (72.4%), high risk of PE (11.3%) and primary prophylaxis (13.8%). Retrieval was attempted in 165 patients (60%) and was successful in 146 patients (53.1%). The most common reason for failed retrieval was filter thrombus. Predictors of attempted retrieval included documentation of filter plan (odds ratio [OR] 16.7; p<0.001), surgical indication for IVC filter insertion (OR 4.8; p=0.002), age ≤70years (OR 3.8; p=0.001), Hematology service involvement (OR 3.0; p=0.006), and presence of metastatic cancer (OR 0.2; p=0.001). Thrombotic complications occurred in 48 patients, including 3 patients who died of fatal PE.
  
  
  CONCLUSIONS
  Our filter retrieval rate is suboptimal. Improvements in follow-up documentation or a dedicated clinical service may help increase retrieval rates.
authors.affiliation: Division of Hematology, Department of Medicine, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.
authors.forename: Erica A
authors.initials: EA
authors.lastname: Peterson
authors.affiliation: Division of Hematology, Department of Medicine, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Yenson
authors.affiliation: Department of Radiology, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.
authors.forename: Dave
authors.initials: D
authors.lastname: Liu
authors.affiliation: Division of Hematology, Department of Medicine, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada. Electronic address: alee14@bccancer.bc.ca.
authors.forename: Agnes Y Y
authors.initials: AY
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D020878:Device Removal / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D013927:Thrombosis / Q000150:complications / Q000209:etiology; D016306:Vena Cava Filters / Q000009:adverse effects; D055815:Young Adult
keywords: Complications; Deep vein thrombosis; Inferior vena cava filter; Prevention; Pulmonary embolism; Venous thromboembolism