Reasons for Failure to Remove Inferior Vena Cava Filters: Retrospective Study in a Tertiary Care and Trauma Centre

Abstract 3141 Background: Inferior vena cava filter (IVCF) use has been rising exponentially since the introduction of percutaneous image guided IVCF placement and the subsequent development of optional recovery models. Optional recovery IVCFs are preferred over permanent devices as an alternative or adjunct to anticoagulation to prevent pulmonary embolism (PE) in patients with venous thromboembolism (VTE) due to their ability to be retrieved once they are no longer needed. In 2010, the US Food and Drug Administration issued a safety alert for optional recovery filters following reports of adverse events associated with their widespread use. Attempted removal rates reported in the literature are suboptimal, ranging from 15 to 70% in single centre studies. We conducted a retrospective study to determine IVCF complications, retrieval rates and barriers to removal in our institution. Methods: Consecutive patients who had a retrievable IVCF inserted or removed by the Interventional Radiology department from January 1 st 2007 to June 30 th 2010 were identified from a prospective database. Data were extracted from chart review using standardized forms. Outcomes collected included indication for IVCF, frequency of removal, documentation of an IVCF plan (for retrieval or not), reasons for non-retrieval, and all-cause mortality. A bivariate comparison of patients who had an attempted IVCF retrieval or not was performed. Patient characteristics were compared using 2-sided t-tests for continuous variables and chi-square analysis for categorical variables. Multivariate analysis by binary logistic regression was performed for significant variables (p Results: 242 patients were identified with a median age of 60 years (range 14–93 y) of which 52.9% were male. Underlying thrombotic conditions included: acute ( Conclusion: Our single-centre IVC filter recovery rate compares favorably to published reports but remains suboptimal. Failure to document a filter plan and age > 70 years were the only predictors of a lower rate of attempted IVC filter recovery. A significant proportion of patients (11.1%) who did not undergo an attempted IVC filter recovery had no identifiable reason not to do so. Improper documentation may play a significant role in failure to recover devices, particularly in patients with no contraindications to removal. Further studies are needed to identify barriers to retrieval and improve removal rates. Disclosures: No relevant conflicts of interest to declare.