A comparison of clinical outcomes with retrievable and permanent inferior vena cava filters

Abstract

Purpose: To compare the clinical effectiveness of retrievable and permanent inferior vena cava (IVC) filters.

Materials and methods: A retrospective cohort study of consecutive patients who received retrievable or permanent IVC filters from January 2002 through December 2006 was conducted. Patient characteristics and clinical outcomes were compared with nonparametric and parametric statistics.

Results: IVC filters were placed in 702 patients: 427 (60.8%) received a retrievable filter (RF) and 275 (39.2%) received a permanent filter (PF). Overall, the mean duration of follow-up was 11.5 months: 10.4 months for RF recipients and 13.1 months for PF recipients (P = .025). PF recipients were older (60.6 y +/- 17.0 vs 55.4 y +/- 17.2; P < .0001) and more likely to have underlying cancer (45.8% vs 29.3%; P < .0001). Symptomatic pulmonary embolism (PE) occurred in 11 PF recipients and 20 RF recipients who were receiving ongoing filtration (4.0% vs 4.7%; P = .67). Patients with PFs and RFs with ongoing filtration experienced symptomatic deep vein thrombosis (11.3% vs 12.6%; P = .59) and symptomatic IVC thrombosis (1.1% vs 0.5%; P = .39) at a comparable frequency. Sixty-six RF recipients (15.5%) underwent attempted retrieval, which was successful in 46 (69.7%). No RF recipients experienced a new PE after retrieval during a mean follow-up of 12.0 months.

Conclusions: In this retrospective cohort study, RFs and PFs provided similar protection from PE with comparable complication rates. Clinicians should select an IVC filter based on the projected duration of filtration needed at the time of placement rather than filter type.