title: Inferior vena cava filter usage, complications, and retrieval rate in cancer patients.
abstract: BACKGROUND
  Venous thromboembolism contributes significantly to morbidity and mortality in cancer patients. Because cancer patients frequently have contraindications to anticoagulation, inferior vena cava filters are commonly placed. The use, safety, and retrieval of retrievable inferior vena cava filters in cancer patients have not been well studied.
  
  
  METHODS
  A retrospective review of retrievable inferior vena cava filter use at a tertiary referral hospital was conducted between January 1, 2009 and December 31, 2011. Indications for inferior vena cava filter placement, anticoagulation practices, complications, filter retrieval, and patient outcomes were analyzed for patients with and without active cancer and for cancer subtypes, including localized and metastatic cases.
  
  
  RESULTS
  Of 666 patients receiving retrievable inferior vena cava filters during this time period, 247 (37.1%) had active cancer. Of these, 151 (22.7%) had carcinoma, 92 (13.8%) had sarcoma, and 115 (17.3%) had metastatic disease. Overall, follow-up was available for a median of 401.0 (interquartile range: 107.5-786.5) days. Indwelling filter-related complications occurred in 19.8% of patients without cancer and 17.7% with an active cancer (P = .50). Patients with cancer were less likely to have the filter retrieved (28.0% vs 42.0%, P < .001). In multivariable analysis, cancer was not associated with filter-related complications but was associated with a lower rate of filter retrieval.
  
  
  CONCLUSIONS
  In a modern cohort of patients undergoing retrievable inferior vena cava filter placement, active diagnosis of cancer is not associated with a significant increase in filter-related complications, but is associated with a reduced rate of filter retrieval.
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Boston, Mass.
authors.forename: Farhad
authors.initials: F
authors.lastname: Abtahian
authors.affiliation: Department of Medicine, University of Oklahoma College of Medicine, Oklahoma City.
authors.forename: Beau M
authors.initials: BM
authors.lastname: Hawkins
authors.affiliation: Department of Hematology and Oncology, Massachusetts General Hospital, Boston, Mass.
authors.forename: David P
authors.initials: DP
authors.lastname: Ryan
authors.affiliation: Medicine Department, Spaulding Rehabilitation Hospital, Boston, Mass.
authors.forename: Philip
authors.initials: P
authors.lastname: Cefalo
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ont., Canada.
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Nasser
authors.affiliation: The Institute for Heart, Vascular and Stroke Care, Massachusetts General Hospital, Boston, Mass.
authors.forename: Cheryl
authors.initials: C
authors.lastname: MacKay
authors.affiliation: The Institute for Heart, Vascular and Stroke Care, Massachusetts General Hospital, Boston, Mass.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jaff
authors.affiliation: The Institute for Heart, Vascular and Stroke Care, Massachusetts General Hospital, Boston, Mass. Electronic address: iweinberg@partners.org.
authors.forename: Ido
authors.initials: I
authors.lastname: Weinberg
mesh_terms: D000925:Anticoagulants; D015331:Cohort Studies; D000075202:Contraindications; D020878:Device Removal / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications* / Q000401:mortality; D011655:Pulmonary Embolism / Q000517:prevention & control; D012189:Retrospective Studies; D016306:Vena Cava Filters / Q000009:adverse effects; D054556:Venous Thromboembolism / Q000150:complications / Q000401:mortality / Q000628:therapy*
chemical_list: D000925:Anticoagulants
keywords: Cancer; Deep venous thrombosis; Inferior vena cava; Malignancy; Pulmonary embolism