A retrospective case control study of the impact of a dedicated service to increase retrieval rates of IVC filters in a Level 1 Trauma centre

Abstract

Purpose

Inferior vena cava (IVC) filters are considered for preventing fatal pulmonary embolism (PE) in patients unable to undergo anticoagulant therapy. Trauma patients face a heightened risk of PE due to immobility and hypercoagulability. Although effective, IVC filters have long-term risks and should be removed when no longer indicated. A dedicated follow-up clinic can improve IVC filter retrieval rates and minimize complications. This study evaluates the impact of a dedicated clinic on retrieval rates, complications, and follow-up.

Methods and Materials

A retrospective analysis was conducted on trauma patients with IVC filters inserted between October 2011 and October 2021. A dedicated trauma clinic, established in January 2018, followed discharged patients with inserted IVC filters. Inclusion criteria included prophylactic and therapeutic indications and emergent presentations. Patients who died during hospitalization or had filters retrieved at other hospitals were excluded.

Results

During the pre-clinic period, 639 IVC filters were inserted, and 380 (59.5 %) were retrieved, with an average dwell time of 200 days. In the post-clinic period, 332 filters were inserted, and 278 (83.8 %) were retrieved, with a reduced average dwell time of 150 days. Complications decreased from 37 cases (average dwell time: 303 days) pre-clinic to 10 cases (average dwell time: 187 days) post-clinic.

Conclusion

The establishment of a dedicated follow-up clinic significantly improved IVC filter retrieval rates and reduced dwell times at this trauma center. This study highlights the value of follow-up clinics in ensuring timely IVC filter retrieval and minimizing complications when filters are no longer clinically required.