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. 2025 Oct 1;15(10):9146-9156.
doi: 10.21037/qims-2025-837. Epub 2025 Sep 17.

Optimizing the management strategy for inferior vena cava filter

Geoffroy Guillaubey  1 , Elie Ayoub  2 , Rémi Grange  1 , Géraldine Poenou  2 , Pierre Cixous  1 , Claire Boutet  3 , Laurent Bertoletti  2 , Sylvain Grange  4
Affiliations

Optimizing the management strategy for inferior vena cava filter

Geoffroy Guillaubey et al. Quant Imaging Med Surg. .

Abstract

Background: Complications related to the inferior vena cava filter (IVCF) increase with prolonged dwell time. We therefore evaluated the efficacy of two new methods of monitoring patients in terms of retrieval rates, and compared them with our previous practice, which did not involve a multidisciplinary (MD) approach.

Methods: From April 1st, 2012 to October 31st, 2019, patients were monitored by the vascular medicine department, without MD follow-up. From November 1st, 2019 to October 31st, 2021, a letter was sent to the patients' general practitioner (GP) to inform them of the need for a specialist consultation to assess whether the filter was still indicated. From November 1st, 2021 to November 1st, 2023, an MD discussion was organised between the radiologist and the vascular physician to assess the indication for retrieval. This discussion systematically reviewed the evolution of the contraindication to anticoagulant therapy (AT), the initial indication for filter implantation, and the patient's life expectancy. If retrieval was considered appropriate, the patient was contacted and scheduled for the removal procedure. The retrieval rates of the different methods and the occurrence of complications were measured in each group and compared.

Results: The overall retrieval rate of IVCFs increased, though not significantly (P=0.15), from 40.5% with no specific follow-up (NSF), to 42.4% when a letter was sent to the GP, and to 49.7% when an MD meeting was implemented. In contrast, the adjusted retrieval rate improved significantly (P<0.001), rising from 62.9% with NSF, to 69.7% with a GP's letter, and reaching 97.5% following an MD meeting.

Conclusions: MD involvement in patient follow-up leads to a significant improvement in the removal of IVCF that are no longer clinically necessary. Sending a letter to the GP is effective, but MD follow-up is more effective.

Keywords: Inferior vena cava filter retrieval (IVCF retrieval); deep vein thrombosis (DVT); optimizing patients’ management; pulmonary embolism (PE).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-2025-837/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Timeline showing the patient monitoring procedures put in place. GP, general practitioner; MD, multidisciplinary.
Figure 2
Figure 2
Flow chart showing the distribution of patients with IVCF. GP, general practitioner; IVCF, inferior vena cava filter; MD, multidisciplinary; NSF, no specific follow-up.
Figure 3
Figure 3
Injected CT scan performed during follow-up, presented in coronal section, showing thrombosis of the IVCF. The filter (white arrowhead) is thrombosed, and the thrombus extends downstream of the filter (black arrow) and upstream (white arrow). CT, computed tomography; IVCF, inferior vena cava filter.
See this image and copyright information in PMC

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