Semin intervent Radiol 2011; 28(1): 118-127
DOI: 10.1055/s-0031-1273946
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Improving the Tracking and Removal of Retrievable Inferior Vena Cava Filters

Anthony D. Goei1 , Shellie C. Josephs2 , Thomas B. Kinney3 , Charles E. Ray, David Sacks5
  • 1Department of Radiology, Fort Sam Houston, Texas
  • 2Department of Radiology, University of Texas Southwestern Medical School, Dallas, Texas
  • 3Department of Clinical Radiology, University of California at San Diego, San Diego, California
  • 4Department of Radiology, University of Colorado Denver, Aurora, Colorado
  • 5Advanced Interventional Radiology, The Reading Hospital and Medical Center, West Reading, Pennsylvania
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Publikationsdatum:
22. März 2011 (online)

ABSTRACT

Therapeutic and prophylactic inferior vena cava (IVC) filters should be placed based on currently accepted indications to prevent a fatal pulmonary embolism (PE). The protective effect of filters is offset by the potential for lower extremity deep venous thrombosis (DVT), caval thrombosis, and possible otherwise unnecessary life-long anticoagulation (AC). The duration of treatment for most DVTs or PEs is 3 to 6 months of AC/filter. Filters should be retrieved when duration of treatment for a DVT/PE has been met, the risk of a PE is no longer high, and/or there is no longer a contraindication to AC. An effective system that leads to improving the retrieval rate of filters must include education of the patient, a tracking system to minimize patient lost to follow-up, and dedicated personnel to oversee the process. If these goals are accomplished, interventionalists can help decrease the incidence of a fatal PE during the high-risk period, and also decrease the risk of a DVT or the use of otherwise unnecessary life-long AC in subsequent years. Currently, there is much room for improvement in the frequency that IVCF patients are systematically followed and filters are retrieved. The principles discussed in this report will be helpful in this process.

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Anthony D GoeiM.D. F.A.C.S. 

Department of Radiology, 3851 Roger Brooke Drive, Fort Sam Houston

TX 78234

eMail: anthony.goei@amedd.army.mil; tkgoei@aim.com