Inferior vena cava filters (IVCF) are associated with complications which may be due
to delayed retrieval. Initiation of an automated reminder system may improve retrieval
rates and reduce complications. A computerized reminder system, which provides interactive
email reminders after implantation while collecting IVCF use data, was implemented.
IVCF retrieval was compared before (“reminder not provided” group) and after (“reminder
provided” group) implementation. Data regarding implantation, retrieval, and complications
were collected. The primary efficacy outcome was retrieval rate, and the primary safety
outcome was indwelling complication rate. Secondary outcomes were time to retrieval
and a composite adverse outcome defined as IVCF thrombosis, deep venous thrombosis
(DVT), pulmonary embolism, and death. A total of 1,070 IVCF insertions were included,
715 in the “reminder not provided” group and 355 in the “reminder provided” group.
Patient age (61 vs 64 years, p = 0.95) and gender (42% vs 40% female, p = 0.55) were
similar in the “reminder not provided” and “reminder provided” groups, respectively.
In the “reminder provided” group, the retrieval rate was higher (148/297 [49.8%] vs
223/715 [31.2%], p = 0.0001), the indwelling complication rate was lower (30/319 [9.4%]
vs 115/715 [16.1%], p = 0.005), and the time to retrieval was shorter (112 days vs
146 days, p = 0.02). The composite adverse outcome occurred less frequently in the
“reminder provided” group: (85/355 [23.9%] vs 297/715 [41.5%], p = 0.0001). The system
was associated with increased odds of IVCF retrieval (odds ratio 2.56; 95% confidence
interval: 1.82 to 3.59; p <0.0001) and reduced odds of the composite adverse outcome
(odds ratio 0.72; 95% confidence interval: 0.60 to 0.80; p <0.0001). In conclusion,
implementing a computerized email reminder system was associated with higher IVCF
retrieval rates, fewer indwelling complications, and shorter dwell times.
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References
- Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism.Circulation. 2005; 112: 416-422
- Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial.JAMA. 2015; 313: 1627-1635
- Vena cava filter utilization and outcomes in pulmonary embolism: Medicare hospitalizations from 1999 to 2010.J Am Coll Cardiol. 2016; 67: 1027-1035
- Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial.JAMA. 2015; 313: 1627-1635
- Effect of delayed inferior vena cava filter retrieval after early initiation of anticoagulation.Am J Cardiol. 2014; 113: 389-394
- Anticoagulation Is Associated with Decreased Inferior Vena Cava Filter-Related Complications in Patients with Metastatic Carcinoma.Am J Med. 2017; 130: 77-82
- Indications, complications, and management of inferior vena cava filters: the experience in 952 patients at an academic hospital with a level I trauma center.JAMA Intern Med. 2013; 173: 513-517
US Food & Drug Administration. Removing retrievable inferior vena cava filters: FDA safety communication. 2014. <https://wayback.archive-it.org/7993/20170722215731/ https://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm396377.htm>;
- Systematic review of the use of retrievable inferior vena cava filters.J Vasc Interv Radiol. 2011; 22: 1522-1530
- Retrieval rates of inferior vena cava (IVC) filters: are we retrieving enough?.N Z Med J. 2015; 128: 31-40
- Improving the retrieval rate of inferior vena cava filters with a multidisciplinary team approach.J Vasc Surg Venous Lymphat Disord. 2016; 4: 276-282
- A policy of dedicated follow-up improves the rate of removal of retrievable inferior vena cava filters in trauma patients.Am Surg. 2011; 77: 103-108
- Improving retrieval rates of temporary inferior vena cava filters.J Vasc Surg. 2011; 54 (34S-8S)
- Effect of delayed inferior vena cava filter retrieval after early initiation of anticoagulation.Am J Cardiol. 2014; 113: 389-394
- Rates and predictors of plans for inferior vena cava filter retrieval in hospitalized patients.J Gen Intern Med. 2010; 25: 321-325
- A method for following patients with retrievable inferior vena cava filters: results and lessons learned from the first 1,100 patients.J Vasc Interv Radiol. 2011; 22: 1507-1512
- A systematic method for follow-up improves removal rates for retrievable inferior vena cava filters in a trauma patient population.J Trauma. 2010; 69: 866-869
- Improving inferior vena cava filter retrieval rates: impact of a dedicated inferior vena cava filter clinic.J Vasc Interv Radiol. 2010; 21: 1847-1851
- Implementation of an institutional protocol to improve inferior vena cava utilization and outcomes.J Thromb Thrombolysis. 2017; 44: 190-196
- Improving inferior vena cava filter retrieval rates with the define, measure, analyze, improve, control methodology.J Vasc Interv Radiol. 2015; 26: 491-498
- Radiology-led follow-up system for IVC filters: effects on retrieval rates and times.Cardiovasc Interv Radiol. 2012; 35: 309-315
- Institutional protocol improves retrievable inferior vena cava filter recovery rate.Surgery. 2009; 146: 809-816
- A multidisciplinary quality improvement program increases the inferior vena cava filter retrieval rate.Vasc Med. 2017; 22: 51-56
- Retrospective review of 120 celect inferior vena cava filter retrievals: experience at a single institution.J Vasc Interv Radiol. 2012; 23: 1557-1563
Article Info
Publication History
Published online: October 18, 2018
Received in revised form:
September 19,
2018
Received:
July 12,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.