Goodin Amie, Han Qiong, Raissi Driss, Brown Joshua D
Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, FL.
Department of Radiology, University of Kentucky College of Medicine, Lexington, KY.
Ann Vasc Surg. 2018 Aug;51:284-297. doi: 10.1016/j.avsg.2018.02.010. Epub 2018 Apr 13.
Inferior vena cava filters (IVCFs) are indicated for therapeutic and prophylactic treatment of venous thromboembolism in patients when anticoagulation has failed or is contraindicated. Retrievable IVCFs are not always retrieved despite clinical recommendations. The purpose of this review is to compare results in the literature regarding interventions and to improve IVCF retrieval rates.
Articles were identified via the search terms "vena cava filters" and "inferior vena cava filters" in conjunction with "retrieval." Searches were repeated in MEDLINE/PubMed, Google Scholar, and Cochrane database. Exclusion criteria included duplicates, misidentified subject matter, study period before 2008, and lack of control group. Two independent reviewers screened key elements in the identified manuscripts, including the targeted intervention population, study design, IVCF retrieval rates, and other outcomes. A third reviewer corroborated results and consolidated findings.
Seventeen articles were identified for review. Of these, 12 were physician-targeted interventions, and 8 were patient-targeted interventions (3 studies included both). IVCF retrieval rates varied substantially for each study, but all reviewed studies reported improvement in retrieval rate following intervention. Only 5 studies reported decreased IVCF indwell times in intervention groups. Reported complication rates from IVCF retrievals were low, ranging from 0 to 2%.
IVCF retrieval rates were improved by all interventions in the reviewed studies. Findings suggest that IVCF retrieval rates can be best improved by tracking patients typically lost to follow-up. Literature suggests that successful tracking requires an individual or team of individuals who have been assigned dedicated clinical responsibility for coordinating care following IVCF placement.
当下腔静脉滤器（IVCF）在抗凝治疗失败或存在禁忌证时，可用于静脉血栓栓塞症患者的治疗和预防。尽管有临床建议，但可回收式IVCF并非总能被取出。本综述的目的是比较文献中关于干预措施的结果，以提高IVCF取出率。
通过在MEDLINE/PubMed、谷歌学术和Cochrane数据库中搜索“腔静脉滤器”和“下腔静脉滤器”并结合“取出”等检索词来识别文章。排除标准包括重复文章、主题识别错误、2008年以前的研究时间段以及缺乏对照组。两名独立评审员筛选了已识别手稿中的关键要素，包括目标干预人群、研究设计、IVCF取出率和其他结果。第三名评审员核实了结果并汇总了研究发现。
共识别出17篇文章进行综述。其中，12篇是针对医生的干预措施，8篇是针对患者的干预措施（3项研究同时包括两者）。每项研究的IVCF取出率差异很大，但所有综述研究均报告干预后取出率有所提高。只有5项研究报告干预组的IVCF留置时间缩短。报告的IVCF取出并发症发生率较低，范围为0%至2%。
综述研究中的所有干预措施均提高了IVCF取出率。研究结果表明，通过追踪通常失访的患者，可最佳地提高IVCF取出率。文献表明，成功的追踪需要有专人或团队负责在IVCF置入后协调护理工作。
