Shaikh Saba S, Kamath Suneel D, Ghosh Debashis, Lewandowski Robert J, McMahon Brandon J
Northwestern University Feinberg School of Medicine, Department of Medicine, Chicago, IL 60611, USA.
Northwestern University Feinberg School of Medicine, Department of Medicine, Division of Hematology/Oncology, USA.
Int J Vasc Med. 2020 Feb 5;2020:6582742. doi: 10.1155/2020/6582742. eCollection 2020.
The role for inferior vena cava (IVC) filters in the oncology population is poorly defined.
Our primary endpoint was to determine the rate of filter placement in cancer patients without an absolute contraindication to anticoagulation and the rate of recurrent VTE after filter placement in both retrievable and permanent filter groups. /.
A single-institution, retrospective study of patients with active malignancies and acute VTE who received a retrievable or permanent IVC filter between 2009-2013. Demographics and outcomes were confirmed on independent chart review. Cost data were obtained using Current Procedural Terminology (CPT) codes.
179 patients with retrievable filters and 207 patients with permanent filters were included. Contraindication to anticoagulation was the most cited reason for filter placement; however, only 76% of patients with retrievable filters and 69% of patients with permanent filters had an absolute contraindication to anticoagulation. 20% of patients with retrievable filters and 24% of patients with permanent filters had recurrent VTE. The median time from filter placement to death was 8.9 and 3.2 months in the retrievable and permanent filter groups, respectively. The total cost of retrievable filters and permanent filters was $2,883,389 and $3,722,688, respectively.
The role for IVC filters in cancer patients remains unclear as recurrent VTE is common and time from filter placement to death is short. Filter placement is costly and has a clinically significant complication rate, especially for retrievable filters. More data from prospective, randomized trials are needed to determine the utility of IVC filters in cancer patients.
下腔静脉（IVC）滤器在肿瘤患者中的作用尚不清楚。
我们的主要终点是确定在无抗凝绝对禁忌证的癌症患者中滤器置入率，以及在可回收和永久性滤器组中滤器置入后复发性静脉血栓栓塞（VTE）的发生率。
一项单机构回顾性研究，研究对象为2009年至2013年间患有活动性恶性肿瘤和急性VTE且接受了可回收或永久性IVC滤器的患者。通过独立的病历审查确认人口统计学和结局数据。使用现行程序术语（CPT）编码获取成本数据。
纳入了179例使用可回收滤器的患者和207例使用永久性滤器的患者。抗凝禁忌证是滤器置入最常提及的原因；然而，只有76%使用可回收滤器的患者和69%使用永久性滤器的患者有抗凝绝对禁忌证。20%使用可回收滤器的患者和24%使用永久性滤器的患者发生了复发性VTE。在可回收滤器组和永久性滤器组中，从滤器置入到死亡的中位时间分别为8.9个月和3.2个月。可回收滤器和永久性滤器的总成本分别为2,883,389美元和3,722,688美元。
IVC滤器在癌症患者中的作用仍不明确，因为复发性VTE很常见，且从滤器置入到死亡的时间很短。滤器置入成本高昂，且有临床显著的并发症发生率，尤其是可回收滤器。需要更多来自前瞻性随机试验的数据来确定IVC滤器在癌症患者中的效用。
