Comparative analysis of technical success rates and procedural complication rates of bedside inferior vena cava filter placement by intraprocedural imaging modality

Abstract

Objective: Transabdominal duplex ultrasound, intravascular ultrasound (IVUS), and fluoroscopy have been used to assist with inferior vena cava filter (IVCF) placement since the late 1990s. We sought to compare the technical success and procedural complications of bedside placement of IVCF by the three commonly used modalities, namely, duplex ultrasound, IVUS, and combined IVUS and fluoroscopy.

Methods: All published reports including prospective and retrospective cohort studies and case series with a minimum of 10 patients from inception to August 2017 were identified by an electronic search of PubMed and Embase. The studies were then pooled to create a sample of patient data for statistical analysis. Bonferroni correction was used for comparison of the three groups. Values of P < .017 (two tailed) were considered statistically significant for the pairwise comparisons.

Results: A total of 21 studies comprising 2166 patients were identified. No significant differences were found in technical success and complication rates between the duplex ultrasound and IVUS arm, the combined IVUS and IVUS with fluoroscopy arm, or the duplex ultrasound and the combined IVUS with fluoroscopy arm. However, there was a trend toward decreased complication rates in the duplex ultrasound arm compared with the other two arms. A trend toward increased technical success was also observed in the combined IVUS and fluoroscopy arm compared with the other two arms.

Conclusions: There are no significant differences in the technical success and complication rates between the three commonly used modalities of bedside IVCF placement.

Keywords: Complications; Conventional fluoroscopy; Inferior vena cava bedside placement; Technical success.