Paper presented
Are temporary inferior vena cava filters really temporary?

Presented at the 57th Annual Meeting of the Southwestern Surgical Congress, San Antonio, Texas, April 10–12, 2005
https://doi.org/10.1016/j.amjsurg.2005.08.009Get rights and content

Abstract

Background

Despite significant risk for venous thromboembolism, severely injured trauma patients often are not candidates for prophylaxis or treatment with anticoagulation. Long-term inferior vena cava (IVC) filters are associated with increased risk of postphlebitic syndrome. Retrievable IVC filters potentially offer a better solution, but only if the filter is removed; our hypothesis is that the most of them are not.

Methods

This retrospective study queried a level I trauma registry for IVC filter insertion from September 1997 through June 2004.

Results

One IVC filter was placed before the availability of retrievable filters in 2001. Since 2001, 27 filters have been placed, indicating a change in practice patterns. Filters were placed for prophylaxis (n = 11) or for therapy in patients with pulmonary embolism or deep vein thrombosis (n = 17). Of 23 temporary filters, only 8 (35%) were removed.

Conclusions

Surgeons must critically evaluate indications for IVC filter insertion, develop standard criteria for placement, and implement protocols to ensure timely removal of temporary IVC filters.

Section snippets

Methods

A level I trauma registry was queried for IVC filter insertion in 5799 patients admitted from September 1, 1997, through June 30, 2004. Inclusion criteria consisted of any patient admitted to the trauma service who underwent placement of an IVC filter. Institutional, vascular surgery, and interventional radiology medical records were retrospectively reviewed for patient demographics, Injury Severity Score (ISS), filter type, removal information, complications, and outcomes. Filters were

Frequency of IVC filter placement

In the 44 months before the availability of retrievable filters (September 1, 1997, through April 30, 2001), 1 therapeutic IVC filter was placed. In the 37 months after introduction of the retrievable filter (May 1, 2001, through June 30, 2004), 27 filters were placed, of which 25 (93%) were removable. Filters were placed for therapy in patients with VTE (n = 17) or for prophylaxis (n = 11). Filter placement increased each year, with the most dramatic increase seen in filters placed for

Comments

The use of IVC filters has significantly increased since the availability of retrievable filters. However, our data show that only 35% of retrievable filters were removed. These results indicate that although our practice patterns have changed because of the theoretical advantages of retrievable filters, the majority of filters intended as temporary in fact become permanent.

In 1997, the Eastern Association for the Surgery of Trauma published recommendations for the use of IVC filters in trauma

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