title: Inferior vena cava filters and their varying compliance with the ACCP and the SIR guidelines.
abstract: OBJECTIVE
  We examined our experience with inferior vena cava filters to assess whether we conformed to the American College of Chest Physicians (ACCP) and the Society of Interventional Radiology (SIR) guidelines and to evaluate the reasons for any discrepancy.
  
  
  METHODS
  This was a retrospective medical record review of patients having inferior vena cava filters placed in two New York City hospitals during a 34-month period. The indications for filter placement, the type of filter used, and the conformity with the two guidelines were noted.
  
  
  RESULTS
  A total of 345 filters were placed; 41.4% were permanent and 58.6% were optional. Compliance with SIR guidelines was 95.7% and 41.3% with ACCP guidelines. A total of 173 patients (50.4%) did not conform to the ACCP guidelines while meeting the SIR guidelines. Seventy-one of these patients had a documented venous thromboembolism in the perioperative period, 24 experienced recurrent or progressive venous thromboembolism while on anticoagulation, and 24 were judged to have advanced cardiopulmonary disease. Thirty patients had prophylactic filters, the majority of whom were in the perioperative period. These conditions were the main causes of discrepancy between the guidelines.
  
  
  CONCLUSIONS
  Compliance with the ACCP guidelines is poor in this series; however, much of the discrepancy is based on grade 2C evidence. Only grade 1 evidence will reconcile the differences between the two guidelines.
authors.affiliation: From the Department of Radiology, St Luke's-Roosevelt Hospital Center, New York, and the Department of Radiology, Beth Israel Medical Center, New York, New York.
authors.forename: Roula Bou
authors.initials: RB
authors.lastname: Sader
authors.affiliation: From the Department of Radiology, St Luke's-Roosevelt Hospital Center, New York, and the Department of Radiology, Beth Israel Medical Center, New York, New York.
authors.forename: Adie
authors.initials: A
authors.lastname: Friedman
authors.affiliation: From the Department of Radiology, St Luke's-Roosevelt Hospital Center, New York, and the Department of Radiology, Beth Israel Medical Center, New York, New York.
authors.forename: Eric
authors.initials: E
authors.lastname: Berkowitz
authors.affiliation: From the Department of Radiology, St Luke's-Roosevelt Hospital Center, New York, and the Department of Radiology, Beth Israel Medical Center, New York, New York.
authors.forename: Eric
authors.initials: E
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D019983:Guideline Adherence; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D018579:Patient Selection; D012189:Retrospective Studies; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior
chemical_list: D005343:Fibrinolytic Agents