Departments of Radiology, Surgery and Medicine, The Penn State Heart and Vascular Institute, Milton S. Hershey Medical Center, Penn State University College of Medicine, Hershey, PA 17033, USA.
J Vasc Interv Radiol. 2011 Nov;22(11):1507-12. doi: 10.1016/j.jvir.2011.07.019. Epub 2011 Sep 8.
Patients who have undergone implantation of a retrievable inferior vena cava (IVC) filter require continued follow-up to have the device removed when clinically appropriate and in a timely fashion to avoid potential long-term filter-related complications. The efficacy of a method for patient follow-up was evaluated based on a retrospective review of a single-institutional retrievable IVC filter experience.
Patients with retrievable IVC filters were tracked via a prospectively collected database designed specifically for patient follow-up. Follow-up consisted of periodic review of the electronic medical record. Patients were contacted by mail (at regular intervals one or more times) when removal of the filter was deemed appropriate. A retrospective review of the ultimate fate of the first 1,127 retrievable IVC filters placed at a single institution was performed. Retrieval rates were compared with those seen in the initial experience, during which no structured follow-up was performed.
Of 1,127 filters placed, 658 (58.4%) were removed. Filter removal or declaration of the device as permanent was achieved in 860 patients (76.3%). Filter removal, declaration of the device as permanent, or establishment of the need for continued follow-up was achieved in 941 patients (83.5%). Only 186 patients (16.5%) were lost to follow-up.
The follow-up method described in the present study resulted in a statistically significant difference (P < .001) in the likelihood of a patient returning for IVC filter removal compared with a lack of follow-up (59% vs 24%).
接受可回收下腔静脉(IVC)滤器植入的患者需要持续随访,以便在临床适当且及时的情况下将装置取出,以避免潜在的长期滤器相关并发症。本研究通过回顾性分析单中心可回收 IVC 滤器经验,评估了一种患者随访方法的效果。
通过专门设计用于患者随访的前瞻性收集数据库对具有可回收 IVC 滤器的患者进行跟踪。随访包括定期电子病历复查。当认为需要取出滤器时,通过邮件(定期多次)与患者联系。对一家单机构放置的前 1127 个可回收 IVC 滤器的最终结局进行回顾性分析。与初始经验(未进行结构化随访)相比,比较了回收率。
共放置 1127 个滤器,其中 658 个(58.4%)被取出。860 例(76.3%)患者实现了滤器取出或永久性植入物的宣告。941 例(83.5%)患者实现了滤器取出、永久性植入物的宣告或继续随访的确定。仅有 186 例(16.5%)患者失访。
与缺乏随访相比(59%比 24%),本研究中描述的随访方法显著提高了患者返回接受 IVC 滤器取出的可能性(P<0.001)。