Managing an effective system for retrieving IVC filters: outcomes of a prospective patient database, 2012-2023.

Abstract

Purpose: To evaluate retrievable inferior vena cava (IVC) filter outcomes with a prospectively maintained database and active patient management by interventional radiology (IR).

Materials & methods: Patients with retrievable IVC filters placed by IR from 2012 to 2023 at a single, tertiary institution were tracked in a prospective registry, and follow-up was organized by a designated IR physician assistant. Patients were contacted after the filter was placed by IR and a clinic visit arranged; filter removal was scheduled when deemed appropriate. Retrospective review of filter outcomes, including retrieval, patient death, and need for permanent filtration, was performed.

Results: Over the 12-year study period, 607 retrievable IVC filters were placed: 516 Denali, 63 Eclipse, 19 Günther Tulip, and 9 Celect Platinum. In total, 43% (260) were retrieved, 12% (75) were adjudicated to be permanent, and 42% (253) died with the filter in place. The remaining 3% (19) comprised patients alive with the filter not yet retrieved at study endpoint, 42% (8/19) of which were placed in 2023. Of this cohort, 8 still needed the filter and were being monitored to determine follow-up timing, 2 needed a follow-up appointment, and 9 were lost to follow-up due to repeated no-shows and/or inability to reach the patient despite multiple attempts. Overall, 1.5% (9/607) of all filters placed were not accounted for.

Conclusion: This study demonstrates high accountability (98.5%) of retrievable IVC filters when using a prospective registry actively managed by an IR PA, providing an effective and feasible model for facilitating appropriate follow-up.