CHU de St-Etienne, Service de Radiologie, Hôpital Nord, CHU de St-Etienne, Avenue Albert Raimond, Saint-Etienne, France.
CHU de St-Etienne, Service de Médecine Vasculaire et Thérapeutique, Hôpital Nord, CHU de St-Etienne, Saint-Etienne, Avenue Albert Raimond, Saint-Etienne, France.
Eur Radiol. 2023 Apr;33(4):2585-2592. doi: 10.1007/s00330-022-09266-5. Epub 2022 Dec 15.
Inferior vena cava filter (IVCF) placement is indicated when there is a deep vein thrombosis and/or a pulmonary embolism and a contraindication of anticoagulation. Due to the increased risk of recurrent deep venous thrombosis when left in place, IVCF removal is indicated once anticoagulant treatment can be reintroduced. However, many temporary IVCF are not removed. We aimed to analyze the removal rate and predictors of filter non-removal in a university hospital setting.
We collected all the data of consecutive patients who had a retrievable IVCF inserted at the Saint-Etienne University Hospital (France) between April 2012 and November 2019. Rates of filter removal were calculated. We analyzed patient characteristics to assess factors associated with filter non-removal, particularly in patients without a definitive filter indication. The exclusion of this last category of patients allowed us to calculate an adjusted removal rate.
The overall removal rate of IVCF was 40.5% (IC 95% 35.6-45.6), and the adjusted removal rate was 62.9 % (IC 95% 56.6-69.2%). No major complications were noted. Advanced age (p < 0.0001) and cancer presence (p < 0.003) were statistically significant predictors of patients not being requested to make a removal attempt.
Although most of the filters placed are for therapeutic indications validated by scientific societies, the removal rate in this setting remains suboptimal. The major factors influencing IVCF removal rate are advanced age and cancer presence.
• Most vena cava filters are placed for therapeutic indications validated by scientific societies. • Vena cava filter removal rates in this setting remain suboptimal. • Major factors influencing IVCF removal rate are advanced age and cancer presence.
当下肢深静脉血栓形成（DVT）和/或肺栓塞（PE）且存在抗凝禁忌时，需要置入下腔静脉滤器（IVCF）。由于抗凝治疗重新开始后，IVCF 留在体内会增加复发性 DVT 的风险，因此一旦可以重新开始抗凝治疗，就需要取出 IVCF。然而，许多临时 IVCF 并未取出。我们旨在分析在大学医院环境中，IVCF 未取出的比例及其预测因素。
我们收集了 2012 年 4 月至 2019 年 11 月期间在圣艾蒂安大学医院（法国）连续置入可回收 IVCF 的所有患者的数据。计算了滤器取出率。我们分析了患者特征，以评估与滤器未取出相关的因素，特别是在没有明确滤器适应证的患者中。排除了最后一类患者，使我们能够计算调整后的取出率。
IVCF 的总体取出率为 40.5%（95%CI 35.6-45.6），调整后的取出率为 62.9%（95%CI 56.6-69.2%）。未发生重大并发症。高龄（p<0.0001）和癌症（p<0.003）是患者未被要求尝试取出的统计学显著预测因素。
尽管大多数置入的滤器是为科学协会验证的治疗适应证，但在此环境下，滤器的取出率仍不理想。影响 IVCF 取出率的主要因素是高龄和癌症的存在。
大多数下腔静脉滤器是为科学协会验证的治疗适应证而置入的。
在此环境下，下腔静脉滤器取出率仍不理想。
影响 IVCF 取出率的主要因素是高龄和癌症的存在。
