Pulmonary embolism is a serious health risk for patients with deep vein thrombosis (DVT). The preferred treatment for venous thromboembolism (VTE), PE and DVT, is pharmacologic anticoagulation. The alternate choice for patients unable to receive anticoagulation therapy is IVC filtration. A growing number of patients are receiving inferior vena cava (IVC) filters for the prevention of pulmonary embolism (PE). IVC filters are available as permanent or retrievable. It is important to understand the purpose of caval filtration is not for the prevention or treatment of DVT, but for the prevention of PE by trapping embolus from DVT.
According to the National Guideline Clearinghouse, retrievable filters have a recommended dwell time of 10 to 100 days. The longer a filter is left in, the greater the potential for complications, such as fracture, migration, thrombosis, and embedding in IVC wall. The FDA recommends removal of retrievable filters as soon as the need is no longer present. There is a large discrepancy between the number of retrievable filters placed and the number actually removed. By determining why patients are not having retrievable filters removed, a program can be put into place to increase the retrieval rate.
A retrospective chart review will be done on all patients receiving IVC filters, both permanent and retrievable at a single hospital during a 2-year period. The facility is a community based level 2-trauma center. The chart review will evaluate the patient age, indication for filter placement, type of filter placed, referring practitioners, and retrieval rates in temporary filters. The data will be evaluated to determine if there are commonalities among patients who have had temporary filters placed, but not removed.
This is a literature review of indications for IVC filter placement and removal. A study conducted by Mission, Kerlan, Tan, and Fang (2009) looked at all IVC filter...