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. 2024 Jan;12(1):101648.
doi: 10.1016/j.jvsv.2023.07.005. Epub 2023 Jul 14.

Predictors of retrieval and long-term mortality in patients treated with inferior vena cava filters

Guillermo O Migliaro  1 , Juan A Noya  2 , Omar D Tupayachi Villagómez  2 , Brian N Donato  3 , Jorge G Allin  4 , Gustavo G Leiva  2 , José A Álvarez  2
Affiliations

Predictors of retrieval and long-term mortality in patients treated with inferior vena cava filters

Guillermo O Migliaro et al. J Vasc Surg Venous Lymphat Disord. 2024 Jan.

Abstract

Objective: Inferior vena cava filters (VCFs) are a therapeutic resource for the treatment of patients with thromboembolic disease who have a contraindication to full-dose anticoagulation. In the present study, we report the retrieval rate and long-term mortality of patients receiving optional inferior VCFs and identify the predictors for retrieval and all-cause mortality during follow-up.

Methods: We conducted a retrospective cohort study of 739 consecutive recipients of optional inferior VCFs from January 2002 to December 2021 in two hospitals. Different clinical characteristics and procedure-related variables were included in the analysis. The all-cause mortality rate and retrieval rate and the predictive factors were evaluated using multivariate analysis.

Results: Of the 739 patients, 393 (53%) were women. The mean patient age was 69 ± 15 years. Of the patients, 67% presented with pulmonary thromboembolism and 43% with deep vein thrombosis (DVT). A contraindication to anticoagulation was present for nearly 90% of the patients, mainly (47%) related to the surgical procedure. In addition, 44% of the patients had active cancer. Follow-up data were available for 94% of the patients, with an average follow-up time of 6.08 ± 5.83 years. Long-term mortality was 53%. Cancer (odds ratio [OR], 3.60; 95% confidence interval [CI], 2.22-5.83), age (OR, 1.03; 95% CI, 1.08-1.42), and DVT (OR, 2.01; 95% CI, 1.08-1.42) were identified as independent predictors of mortality. The retrieval rate at follow-up was 33%. The predictors for retrieval included the indication of the filter related to a surgical procedure (OR, 4.85; 95% CI, 2.54-9.59), the absence of cancer (OR, 2.89; 95% CI, 1.45-5.75), and younger age (OR, 0.98; 95% CI, 0.97-0.99).

Conclusions: High long-term mortality was observed. The predictors of mortality were cancer, older age, and DVT. One third of the filters implanted were retrieved. The predictors for retrieval were a contraindication to surgery-related anticoagulation, the absence of cancer, and younger age.

Keywords: Incidence; Mortality; Retrieval; Vena cava filters.

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Figures

Fig 1
Fig 1
Different devices used during the study period.
Fig 2
Fig 2
Trend of inferior vena cava filter (IVCF) placement and retrieval.
See this image and copyright information in PMC

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