A Review of Interventions to Increase Vena Cava Filter Retrieval Rates.

BACKGROUND: Inferior vena cava filters (IVCFs) are indicated for therapeutic and prophylactic treatment of venous thromboembolism in patients when anticoagulation has failed or is contraindicated. Retrievable IVCFs are not always retrieved despite clinical recommendations. The purpose of this review is to compare results in the literature regarding interventions and to improve IVCF retrieval rates.

METHODS: Articles were identified via the search terms "vena cava filters" and "inferior vena cava filters" in conjunction with "retrieval." Searches were repeated in MEDLINE/PubMed, Google Scholar, and Cochrane database. Exclusion criteria included duplicates, misidentified subject matter, study period before 2008, and lack of control group. Two independent reviewers screened key elements in the identified manuscripts, including the targeted intervention population, study design, IVCF retrieval rates, and other outcomes. A third reviewer corroborated results and consolidated findings.

RESULTS: Seventeen articles were identified for review. Of these, 12 were physician-targeted interventions, and 8 were patient-targeted interventions (3 studies included both). IVCF retrieval rates varied substantially for each study, but all reviewed studies reported improvement in retrieval rate following intervention. Only 5 studies reported decreased IVCF indwell times in intervention groups. Reported complication rates from IVCF retrievals were low, ranging from 0 to 2%.

CONCLUSIONS: IVCF retrieval rates were improved by all interventions in the reviewed studies. Findings suggest that IVCF retrieval rates can be best improved by tracking patients typically lost to follow-up. Literature suggests that successful tracking requires an individual or team of individuals who have been assigned dedicated clinical responsibility for coordinating care following IVCF placement.