Pneumology, Hospital Universitari de Bellvitge - Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
Radiology, Hospital Universitari de Bellvitge - Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
Eur J Intern Med. 2021 Apr;86:73-78. doi: 10.1016/j.ejim.2020.12.026. Epub 2021 Jan 7.
Temporary inferior vena cava (IVC) filters are not always retrieved. Information about long-term outcomes of patients with indwelling filters is scarce. Aims of our study were to assess reasons that preclude retrieval of temporary IVC filters and long-term outcomes and causes of death in patients with indwelling filters.
Retrospective observational study including all consecutive patients undergoing IVC filter insertion from January 2009 through December 2018. Patients with permanent filters and those with temporary filters not retrieved were followed from insertion until June 2020.
We included 271 patients with a mean age of 63.8 years. The main indication for filter insertion was acute venous thromboembolism and contraindication for anticoagulation (83%). The filter was deemed as permanent in 24.4% of patients and temporary in 75.6%. Sixty six percent of temporary filters were retrieved; the main cause of non-retrieval was lack of planning / follow-up (57.9%). One hundred twelve patients (41.3%) remained with indwelling filters. After follow-up, 54.5% were alive and 45.5% had died, with a median survival time of 6.19 (95% CI, 2.63-9.75) years. The most frequent cause of death during follow-up was cancer (49%). The frequency of anticoagulant therapy was similar in both groups (57.4%% versus 54.9%).
The main preventable cause of non-retrieval of temporary IVC filters was lack of planning / follow-up. Structured follow-up programs should be implemented to increase retrieval rates. In patients with indwelling filters, the main cause of death was cancer and extended anticoagulation was not associated with survival.
临时下腔静脉滤器（IVC）并非总能取出。关于留置滤器患者的长期结局信息很少。本研究的目的是评估妨碍临时 IVC 滤器取出的原因以及留置滤器患者的长期结局和死亡原因。
回顾性观察性研究，纳入 2009 年 1 月至 2018 年 12 月期间连续接受 IVC 滤器置入的所有患者。对永久性滤器患者和未取出的临时滤器患者，从置入开始随访至 2020 年 6 月。
共纳入 271 例患者，平均年龄 63.8 岁。滤器置入的主要适应证为急性静脉血栓栓塞症和抗凝禁忌（83%）。24.4%的患者认为滤器是永久性的，75.6%的患者认为滤器是临时性的。66%的临时滤器被取出；未取出的主要原因是缺乏计划/随访（57.9%）。112 例（41.3%）患者仍留有留置滤器。随访后，54.5%存活，45.5%死亡，中位生存时间为 6.19 年（95%CI，2.63-9.75）。随访期间最常见的死亡原因为癌症（49%）。两组抗凝治疗的频率相似（57.4%比 54.9%）。
临时 IVC 滤器未取出的主要可预防原因是缺乏计划/随访。应实施结构化随访方案以提高取出率。在留置滤器的患者中，主要死亡原因为癌症，延长抗凝治疗与生存无关。
