Active surveillance strategies to improve rates of inferior vena cava filter retrieval
1. In this retrospective cohort study, rates of inferior vena cava (IVC) filter retrieval were improved when implanting physician teams adopted an active surveillance strategy.Â
Evidence Rating Level 2: (Good)
Retrievable inferior vena cava filters are effective tools for the prevention of venous thromboembolism-related morbidity and mortality when anticoagulation is contraindicated. Retrievable IVC filters provide the greatest benefit to patients when removed within 90 days, with longer delays contributing to complications, such as filter fracture (up to 21%) and vessel or organ perforation (up to 12.4%). This retrospective cohort study assessed the medical records of 699 patients from a single institution with IVC filters placed between June 2011 and September 2019 to determine whether active surveillance by implanting physicians improved retrieval rates of IVC filters compared to passive surveillance. Prior to 2016, retrieval was organized passively via letters mailed to patients and physicians. Following 2016, physicians adopted an active surveillance model, whereby eligibility for retrieval was discussed with patients over the phone periodically by the implanting physician team. In this study, 55.2% of patients were followed by passive surveillance, and 44.8% were followed by active surveillance. With the adoption of active surveillance in 2016, filter retrieval increased from 48.7% to 61.4% per year, p<0.001. This study demonstrates that a significant increase in IVC filter removal was observed when the implanting physician team assumed the active surveillance model. This finding suggests that rates of IVC filter retrieval should improve if more physicians choose an active surveillance approach.
Click to read the study in JAMA Network Open
Image: PD
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