Clinical evaluation of retrievable inferior vena cava filters for the prevention of pulmonary thromboembolism.
Deep vein thrombosis
Inferior vena cava filter
Pulmonary embolism
Journal
Heart and vessels
ISSN: 1615-2573
Titre abrégé: Heart Vessels
Pays: Japan
ID NLM: 8511258
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
17
10
2020
accepted:
09
04
2021
pubmed:
16
4
2021
medline:
15
2
2022
entrez:
15
4
2021
Statut:
ppublish
Résumé
Inferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been increasingly used to prevent acute pulmonary thromboembolism (PTE) and allow retrieval upon reduction of PTE risk. However, the outcomes of their use in Japan remain unknown. This study retrospectively investigated the acute PTE relapse prevention rate, IVCF retrieval attempt rate, retrieval success rate, and long-term prognosis of 197 patients who underwent r-IVCF insertion at our hospital between 2010 and 2018. Subjects had a mean age of 68 years and a male-to-female ratio of 1:1. After r-IVCF insertion, the acute PTE prevention rate was 99.5%. The r-IVCF retrieval rate was 55% (108 patients), with a success rate of 99% (107 patients). r-IVCF retrieval was not attempted in 89 cases due to advanced cancer or poor prognosis (41%), loss to follow-up (32%), and long-term indwelling IVCF (17%). The retrieval group had an average observation period of 36 months, with their anticoagulation therapy continuation, PTE recurrence, and deep vein thrombosis (DVT) recurrence rates being 64%, 3%, and 4%, respectively. The non-retrieval group had a mean observation period of 21 months, with their anticoagulation continuation, PTE recurrence, and DVT recurrence rates being 78%, 3%, and 15%, respectively. DVT recurrence rates increased significantly in the non-retrieval group (p < 0.01). Moreover, 65% of all DVTs occurred centrally from the femoral veins, among which 9% were contraindicated for anticoagulation therapy. IVCF placement significantly prevented acute PTE but promoted recurrent DVTs when not retrieved after risk reduction. Hence, to increase recovery rates, IVCFs be promptly removed when no longer necessary.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Inferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been increasingly used to prevent acute pulmonary thromboembolism (PTE) and allow retrieval upon reduction of PTE risk. However, the outcomes of their use in Japan remain unknown.
METHODS
METHODS
This study retrospectively investigated the acute PTE relapse prevention rate, IVCF retrieval attempt rate, retrieval success rate, and long-term prognosis of 197 patients who underwent r-IVCF insertion at our hospital between 2010 and 2018.
RESULTS
RESULTS
Subjects had a mean age of 68 years and a male-to-female ratio of 1:1. After r-IVCF insertion, the acute PTE prevention rate was 99.5%. The r-IVCF retrieval rate was 55% (108 patients), with a success rate of 99% (107 patients). r-IVCF retrieval was not attempted in 89 cases due to advanced cancer or poor prognosis (41%), loss to follow-up (32%), and long-term indwelling IVCF (17%). The retrieval group had an average observation period of 36 months, with their anticoagulation therapy continuation, PTE recurrence, and deep vein thrombosis (DVT) recurrence rates being 64%, 3%, and 4%, respectively. The non-retrieval group had a mean observation period of 21 months, with their anticoagulation continuation, PTE recurrence, and DVT recurrence rates being 78%, 3%, and 15%, respectively. DVT recurrence rates increased significantly in the non-retrieval group (p < 0.01). Moreover, 65% of all DVTs occurred centrally from the femoral veins, among which 9% were contraindicated for anticoagulation therapy.
CONCLUSIONS
CONCLUSIONS
IVCF placement significantly prevented acute PTE but promoted recurrent DVTs when not retrieved after risk reduction. Hence, to increase recovery rates, IVCFs be promptly removed when no longer necessary.
Identifiants
pubmed: 33856536
doi: 10.1007/s00380-021-01856-5
pii: 10.1007/s00380-021-01856-5
doi:
Substances chimiques
Anticoagulants
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1756-1764Informations de copyright
© 2021. Springer Japan KK, part of Springer Nature.
Références
Decousus H, Leizorovicz A, Parent F, Page Y, Tardy B, Girard P, Laporte S, Faivre R, Charbonnier B, Barral G, Huet Y, Simonneau G (1998) A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prevention du Risque d’Embolie Pulmonaire par Interruption Cave Study Group. N Engl J Med 338:409–415
doi: 10.1056/NEJM199802123380701
PREPIC Study Group (2005) Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism the PREPIC randomized study. Circulation 112:416–422
doi: 10.1161/CIRCULATIONAHA.104.512834
Weinberg I, Kaufman J, Jaff M (2013) Inferior vena cava filters. JACC Cardiovasc Interv 6:539–547
doi: 10.1016/j.jcin.2013.03.006
Zhou D, Moon E, Bullen J, Sands M, Levitin A, Wang W (2014) Penetration of Celect inferior vena cava filters: retrospective review of CT scans in 265 patients. Am J Roentgenol 202:643–647
doi: 10.2214/AJR.13.11097
Angel L, Tapson V, Galgon R, Restrepo M, Kaufman J (2011) Systematic review of the use of retrievable inferior vena cava filters. J Vasc Interv Radiol 22:1522–1530
doi: 10.1016/j.jvir.2011.08.024
Pharmaceutical and Food Safety Bureau of the Ministry of Health, Labour and Welfare: Instructions for revision of package inserts related to inferior vena cava filters (2011) Safety information on pharmaceuticals and medical devices. 22:70–74
Tao M, Montbriand J, Eisenberg N, Kenneth W, Sniderman G (2016) Temporary inferior vena cava filter indications, retrieval rates, and follow up management at a multicenter tertiary care Institution. J Vasc Surg 64:430–437
doi: 10.1016/j.jvs.2016.02.034
Stavropoulos SW, Sing RF, Elmasri FS et al (2014) An interim analysis of a prospective, multicenter study of the Denali retrievable inferior vena cava filter. J Vasc Interv Radiol. 25:1497–1505
doi: 10.1016/j.jvir.2014.07.001
Sakuma M, Nakamura M, Nakanishi N, Miyahara Y, Tanabe N, Yamada N, Kuriyama T, Kunieda T, Sugimoto T, Nakano T, Shirato K (2004) Inferior vena cava filter is a new additional therapeutic option to reduce mortality from acute pulmonary embolism. Circ J 68:816–821
doi: 10.1253/circj.68.816
JCS Joint Working Group: Guideline for diagnosis, treatment, and prevention of pulmonary thromboembolism and deep vein thrombosis (revised 2017)
Imberti D, Bianchi M, Farina A, Siragusa S, Silingardi M, Ageno W (2005) Clinical experience with retrievable vena cava filters: results of a prospective observational multicenter study. J Thromb Haemost 3:1370–1375
doi: 10.1111/j.1538-7836.2005.01448.x
Dinglasan LA, Oh JC, Schmitt JE, Trerotola SO, Shlansky-Goldberg RD, Stavropoulos SW (2013) Complicated inferior vena cava filter retrievals: associated factors identified at preretrieval CT. Radiology 266(1):347–354
doi: 10.1148/radiol.12120372
Hiroshi A, Kichikawa K, Yoshiyama Y (2015) Retrieval of optimal vena cava filters: A single institute experience and proposing the orotocol for assured retrieval. Jpn J Phlebol 26:53–60
doi: 10.7134/phlebol.15-04