Optimizing the management strategy for inferior vena cava filter

Introduction

Venous thromboembolism (VTE) is a frequent disease, affecting 1/1,000 person per year in Europe (1). This entity includes pulmonary embolism (PE) and deep vein thrombosis (DVT). VTE is potentially serious with 5–10% mortality rate at 3 months for PE. Treatment of this condition usually consists of anticoagulant therapy (AT). The inferior vena cava filter (IVCF) is an implantable medical device placed via a transvenous approach to limit the migration of thrombus to the right cardiac chambers and pulmonary arteries. Indications vary according to the different professional societies. Indications for insertion and removal are constantly evolving, as in the particular case of cancers (2). The most recognized indications for this device are cases of DVT or PE occurring in patients with contraindications or proven ineffectiveness of AT (3-8). Indications are summarized in Figure S1.

The efficacy of IVCF in preventing the occurrence or recurrence of PE in patients with DVT has been proven (9-12). Some studies raise doubts about clinical benefit (13), especially for stable patients (14). A meta-analysis published showed their effectiveness in reducing the incidence of PE, but not all-cause or PE-related mortality (15).

However, complications have been reported in patients with IVCF, such as filter thrombosis, migration (16), or perforation (17). These complications appear to be associated with the length of time the IVCF remains in place (18). For example, in the Manufacturer and User Facility Device Experience (MAUDE) database, only one complication occurred within 30 days of placement (19). Compared to permanents filters, retrievable IVCFs appear to be associated with a higher risk of complications over time, suggesting a reduced structural durability during prolonged implantation (20,21). The IVCF removal procedure is now a common and safe procedure. The overall complication rate during the retrieval procedure remains low. However, the most common event is the failure to retrieve the IVCF (22).

Removal of the IVCF is therefore indicated as soon as the contraindications to anticoagulant treatment have been lifted, usually 3 months after insertion (23). However, previous studies show a tendency for patients not to have their IVCF removed, which may be explained by a lack of patient follow-up (24-29).

Rate of patients lost to follow-up after IVCF placed is reported at 37.1% (30). A better follow-up of patients would improve the rate of retrieval, with the aim of limiting the occurrence of complications (31-34).

The aim of this monocentric retrospective study conducted at the Saint-Etienne University Hospital (France) was to evaluate the impact of three distinct strategies on the retrieval rate of IVCFs. Specifically, it compared the effectiveness of the historical approach with no specific follow-up (NSF) to two other strategies: sending a reminder letter to the general practitioner (GP) and implementing a multidisciplinary (MD) approach, in terms of their respective filter removal rates. We present this article in accordance with the STROBE reporting checklist (available at https://qims.amegroups.com/article/view/10.21037/qims-2025-837/rc).

Methods

Study population

The present retrospective study included all patients who underwent IVCF implantation between April 1^st, 2012 and November 1^st, 2023. All patients with IVCF inserted in the University Hospital of Saint-Etienne were included, with no exclusion criteria. Patients were collected using the hospital’s electronic medical record.

We examined the radiology database, independently of the electronic medical record, to identify all IVCFs implanted during this period. This database contains reports on the IVCF installation and retrieval procedures, as well as the corresponding images. All medical records have been analyzed by radiologists from the interventional radiology department.

IVCF indications

In the University Hospital of Saint-Etienne, the accepted indications for IVCF placement are those recognized by the French Society of Radiology. These include the occurrence of acute proximal DVT or PE in patients with a contraindication to AT, or the recurrence of VTE in patients already treated with effective-dose AT. IVCF placement is also indicated in peri-operative settings in patients requiring AT for VTE, or in severe trauma patients at high risk of thrombosis with a contraindication to AT (Figure S1). During vascular medicine consultations, the elements used to assess the persistence of the IVCF’s indication include resolution of the thrombotic episode, the search for complications linked to AT, and the evolution of underlying diseases in order to predict life expectancy. The indications selected for the permanent IVCF were persistence or worsening of thrombosis after reintroduction of AT, future contraindications to AT in patients at high risk of VTE, and reduced life expectancy. The pharmacological background was not systematically evaluated, as it did not modify patient management in this setting.

IVCF insertion procedure

In the University Hospital of Saint-Etienne, all indications for IVCF insertion and removal are examined by a doctor from the Vascular Medicine and Therapeutics Department (VMTD). All interventional radiology procedures were performed by one of the department’s interventional radiologists with over 5-year experience in radiology. All IVCF inserted were ALN filters (ALN Implants Chirurgicaux, Bormes les Mimosas, France). From June 3^th, 2021, Optional Anti-Tilting Filter (OATF) developed by ALN was implanted.

Before insertion, an ultrasound of the lower limb’s deep vein was performed. Right femoral vein was preferred if permeable, otherwise left femoral, right brachial, and jugular vein were also used. IVCF insertions are performed using biplane fluoroscopy (Siemens Artis Zee Biplane, Siemens Healthineers, Erlangen, Germany) or two successive incidences in monoplane fluoroscopy (Philips Azurion, Philips Healthcare, Best, The Netherlands), with the patient’s consent and under local anesthesia. Firstly, cavography is systematically conducted with subtracted angiographic images obtained in frontal and coronal projection during injection of contrast medium (Visipaque 320, Guerbet, Villepinte, France) at flow rate of 25 mL in 12 cc/s. If no thrombus was detected in the vena cava, the IVCF insertion procedure could proceed.

IVCF retrieval procedure

A Doppler ultrasound of bilateral deep veins was performed just before IVCF removal, in order to ensure that IVCF is permeable and there is no residual thrombus in lower limbs and ilio-cava veins. Right jugular access was used and cavography was performed with the same parameters as for placement to ensure the absence of residual thrombus. The IVCF was removed using a dedicated retrieval device (ALN^® removal pincer, ALN Implants Chirurgicaux). A second venogram of the inferior vena cava using the same parameters was obtained to confirm the absence of complications.

Various monitoring methods

Patients were eligible for IVCF removal if they were alive and there was no indication of long-term IVCF placement. Eligibility started 3 months from IVCF insertion, as long as the patient did not meet any ineligibility criteria (death or definitive indication). For each period studied, patient follow-up ended 3 months after the end of the period in which they were included.

Firstly, we reviewed and analysed all patients from April 1^st, 2012 to October 31^st, 2019, these patients were considered as the control group for analysis (NSF group). For patient who had undergone IVCF placement after November 1^st, 2019, two successive methods were tested to enable lost patients to be referred to a specialist consultation. Then, two different methods were evaluated.

From November 1^st, 2019 to October 31^st, 2021, a letter was sent to the GP group whose IVCF had not been removed, excluding those whose IVCF were permanently indicated and those who had died. Briefly, the purpose of the letter was to remind that patients still had an implanted medical device whose indication had to be assessed by a doctor specializing in vascular pathology, and inviting the patient to contact the VMTD. Then, from November 1^st, 2021 to November 1^st, 2023, all patients whose IVCF had not been removed were assessed at 3 months during an MD staff meeting attended by interventional radiologists and vascular physicians. Patients with an indication for IVCF removal were directly invited to a vascular medicine consultation. The vascular medicine secretariat contacted each patient by telephone to inform them and sent a formal invitation by e-mail. If patients could not be reached by either of these means, they were considered lost to follow-up. Follow-up time line is detailed in Figure 1 (MD group).

Figure 1 Timeline showing the patient monitoring procedures put in place. GP, general practitioner; MD, multidisciplinary.

Data analysis

Categorical variables were expressed as counts and percentages, and quantitative variables as median and interquartile range. Patient characteristics were compared using a Chi-squared test for categorical variables and two-sided t-tests for continuous variables (univariate comparison). All statistical analyses were performed using R analysis software (version 4.4.0). Values of P<0.05 were considered statistically significant.

Ethical approval

The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The study was approved by the Institutional Ethics Board of University Hospital of Saint-Etienne (IRBN 472022/CHUSTE), and informed consent statement was obtained for all participants.

Results

Population

Between April 1^st, 2012 and November 1^st, 2023, 636 IVCF were implanted. Figure 2 represents the patient flow in each group. Demographic data are presented in Table 1. The mean age of patients was 69.8±14.7 years. There was no significant difference between groups for age, gender, or body mass index (BMI) (P>0.05). Active cancer was present for 280 (44.0%) of the 636 patients at the time of IVCF placement. There was a small but statistically significant difference in the proportion of active cancers between groups (P=0.04).

Figure 2 Flow chart showing the distribution of patients with IVCF. GP, general practitioner; IVCF, inferior vena cava filter; MD, multidisciplinary; NSF, no specific follow-up.

Procedure

IVCF placement is presented in Table 2. Most IVCFs were positioned via the right femoral vein in 429 procedures (67.0%). IVCFs were positioned supra-renally in 23 (3.6%) procedures, due to extensive inferior vena cava thrombosis or pregnancy. Patients were transferred from another hospital center for IVCF insertion in 119 (18.7%) of the cases. One hundred and eleven (17.5%) IVCF were inserted during on-call hours.

Indication

Indications for IVCF placement are resumed in Table 3. The main indication for IVCF placement was acute VTE with a contraindication to AT in 589 (92.6%). There was a significant difference between the three groups with regard to VTE, as well as in the PE subgroup, but not in the DVT subgroup. Within acute VTE and contraindication to anticoagulation, coagulopathy was a rare indication, and the only one significantly different between the three groups.

IVCF duration before retrieval and complications

Mean dwell-time before retrieval was 220±181 days (Table S1). We observe a trend of non-significant delay increase before withdrawal (P=0.08 for GP vs. NSF group and P=0.71 for MD vs. NFS). The time passed before IVCF retrieval in each group is shown in the form of a survival curve in Figure S2. The indication for IVCF removal was not retained in 252 (39.6%) patients, and the reason was a venous thrombosis discovered during follow-up in 36 (5.6%) patients. This occurred significantly more in the NSF group, with 28 (7.9%) of patients presenting with a thrombosis (P=0.02). Complications discovered during follow-up are presented in Table S2. Complication during retrieval is shown in Table S3. An example of a thrombosed IVCF is shown in Figure 3.

Figure 3 Injected CT scan performed during follow-up, presented in coronal section, showing thrombosis of the IVCF. The filter (white arrowhead) is thrombosed, and the thrombus extends downstream of the filter (black arrow) and upstream (white arrow). CT, computed tomography; IVCF, inferior vena cava filter.

IVCF overall retrieval rate

The overall rate of IVCF retrieval was 43.0% [95% confidence interval (CI): 39.2–46.9%]. During the NSF period, 356 IVCF were installed. There were 144 retrieval attempts, so the overall retrieval rate of IVCF for this period was 40.5% (95% CI: 35.3–45.6%). During the GP period, 125 IVCF were installed. There were 53 retrieval attempts, so the overall retrieval rate of IVCF for this period was 42.4% (95% CI: 33.7–51.1%). For the MS period, 155 IVCF were installed. There were 77 retrieval attempts, so the overall retrieval rate of IVCF for this period was 49.7% (95% CI: 41.5–57.2%). There was no significant difference between groups for this outcome. Table 4 shows the retrieval rate by group.

Adjusted retrieval rates

Of the 384 IVCF to be removed after checking the indication, 274 removal attempts were assigned, so the global adjusted removal rate was 71.4% (95% CI: 66.8–75.6%). During the NSF period, of the 356 IVCF inserted, 86 patients died before removal and IVCF removal was not indicated for 41 patients. The adjusted retrieval rate was 62.9% (95% CI: 56.6–69.2%). During the GP period, of the 125 IVCF inserted, 47 had not had their IVCF removed, and 15 patients had died. Letters were therefore sent to the GPs of the remaining patients. Only one reply letter was sent, informing us of the patient’s death. The indication for IVCF removal was not retained for 34 patients. The adjusted retrieval rate was 69.7% (95% CI: 59.3–80.1%), and this result was not significantly different from the NSF group (P=0.28). During the MD period, of the 155 IVCF inserted, 25 patients died before removal and retrieval was not indicated for 51 patients. The adjusted retrieval rate was 97.5% (95% CI: 94.0–100.0%), which was significantly higher than the NSF group (P<0.01). For the MD period, of the two patients lost to follow-up, one was a patient not residing in France, and the second failed to attend follow-up appointments despite several written summonses.

Discussion

In a large cohort of patients with IVCF, the present study showed an increasing adjusted retrieval rate with two successive managing methods, increasing from 62.9% to 69.7% in the GP group and to 97.5% in the MD group. Overall retrieval was improved from 40.5% to 42.4% in the GP group and to 49.4% in the MD group, but this was not statistically significant. The MD approach would be the most effective to improve retrieval in light of these results, and almost all IVCF that were no longer indicated have been removed. These results are consistent with those of the Inagaki et al. study, showing an improvement in the rate of attempted removal when an MD protocol is set up with a nurse responsible for monitoring the IVCF placed, with the rate rising from 14% to 66% (33). In this study, the method of calculating the retrieval rate was similar to the adjusted retrieval rate in our work. However, this rate remains lower than the one we found. Their protocol included a systematic 4-week follow-up consultation and a nurse in charge of transmitting technical information on IVCF management to other medical departments. Our MD protocol included inviting lost patients to consultations, i.e., systematically tracking patients who had never or no longer attended follow-up consultations.

The overall IVCF retrieval rate was also increasing in the GP group and in the MD group, however, this difference was not significant. The practices of University Hospital of Saint-Etienne already included scheduling a consultation at the VMTD for all patients in the NSF group, whose IVCF placement indication had been prior validated by the vascular physician, approximately 4 weeks after placement. This may explain a relatively high baseline removal rate compared to other studies. Between the NSF and MD groups, the difference in overall retrieval rates was 8.9%. The non-significance of this result could be related to a lack of power. The study by Sutphin et al. compared to a baseline group the sending of letters to clinicians with the scheduling of systematic consultations (35). Despite a limited number of patients, the authors found that sending letters to clinicians improved the retrieval rate (from 8% to 40%), but it was not the most efficient method with a retrieval rate of 52% with the implementation of a systematic clinical visit (35). This is in line with our results, which show that sending a letter to the GP is more effective than NSF. We also found that the MD approach was more successful than other strategies. This can be explained by the French medical demography, which is facing a lack of GPs, meaning that medical time is in short supply and that the follow-up of IVCF can become a secondary concern.

It can be difficult to compare retrieval rates between different studies for several reasons. Everhart et al. showed, for example, that the removal rate varied according to the therapeutic or prophylactic indication of the IVCF (36). The indications for IVCF placement in the University Hospital of Saint-Etienne were in 92.6% of cases related to acute VTE with contraindication of anticoagulation due to active bleeding or a high risk of bleeding, which was the most consensual among scientific societies (4). There are also heterogeneities in the way retrieval rates are calculated, so we calculated the overall retrieval rate. In our study, overall retrieval rates fell within the range of 4% to 50% reported in a review of 37 publications by Angel et al. (19). We have chosen to focus on what we call the adjusted retrieval rate, which represents the IVCF that really have to be retrieved because the IVCF indication has resolved and it seems to be the most clinically relevant. This calculation method has been used in another study with similar results, Lynch’s study, which showed the effectiveness of prospective patient follow-up using a dedicated database, with an 83.5% adjusted withdrawal rate (37).

The present study is not without limitations. First, it is a retrospective monocentric study, with inherent bias to this type of study. Another limitation was that the groups were discreetly different on some data: cancer, an indication of coagulopathy, presence of PE, the suprarenal filter position, DVT discovered while follow-up. Thus, comparability between groups was not perfect. More, there were no difference groups in terms of mean delay before withdrawal. With GP and MS, we expected to reduce the time to withdrawal, but this was not the case: we observed a trend towards a longer delay in the GP group. We believe that sending a letter to the patient’s GP and wait for a potential reply adds additional processing time. Moreover, the need to hold an MD meeting requires medical time. The cost of such a meeting may be an obstacle to its implementation. In addition, this type of organization may not be possible in all hospitals. More, no multivariate regression analysis was conducted, given the descriptive design of the study and the limited number of patients, which precluded reliable adjustment for all potential confounding variables.

Conclusions

The present study has several original aspects. First, it directly compared three different retrieval management strategies implemented successively in the same institution. Second, the distinction between overall and adjusted retrieval rates provides a precise evaluation of clinically justified removals. Third, the very high adjusted retrieval rate achieved (97.5%) with an MD strategy is, to our knowledge, among the highest reported. Finally, this work focused on a homogeneous population of IVCFs placed mainly for acute VTE with absolute contraindications to anticoagulation, ensuring strong internal validity.

Acknowledgments

We would like to thank Michael J. Deml, PhD, for proofreading the manuscript.

Footnote

Reporting Checklist: The authors have completed the STROBE reporting checklist. Available at https://qims.amegroups.com/article/view/10.21037/qims-2025-837/rc

Data Sharing Statement: Available at https://qims.amegroups.com/article/view/10.21037/qims-2025-837/dss

Funding: None.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-2025-837/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The study was approved by the Institutional Ethics Board of University Hospital of Saint-Etienne (IRBN 472022/CHUSTE), and informed consent statement was obtained for all participants.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

1. Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P, Bengel F, Brady AJ, Ferreira D, Janssens U, Klepetko W, Mayer E, Remy-Jardin M, Bassand JPESC Committee for Practice Guidelines (CPG). Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J 2008;29:2276-315. [Crossref] [PubMed]
2. Fioretti AM, La Forgia D, Scicchitano P, Brunetti ND, Inchingolo R, Tocchetti CG, Oliva S. Inferior Vena Cava Filter in Cancer-Associated Thrombosis: A Vade Mecum for the Treating Physicians: A Narrative Review. Biomedicines 2024;12:2230. [Crossref] [PubMed]
3. Stevens SM, Woller SC, Kreuziger LB, Bounameaux H, Doerschug K, Geersing GJ, Huisman MV, Kearon C, King CS, Knighton AJ, Lake E, Murin S, Vintch JRE, Wells PS, Moores LK. Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report. Chest 2021;160:e545-608. [Crossref] [PubMed]
4. Minocha J, Smith AM, Kapoor BS, Fidelman N, Cain TR, Caplin DM, Eldrup-Jorgensen J, Farsad K, Gupta A, Lee MH, McBride JJ, Moores LK, Rochon PJ, Lorenz JM. ACR Appropriateness Criteria(®) Radiologic Management of Venous Thromboembolism-Inferior Vena Cava Filters. J Am Coll Radiol 2019;16:S214-26. [Crossref] [PubMed]
5. Konstantinides SV, Meyer G. The 2019 ESC Guidelines on the Diagnosis and Management of Acute Pulmonary Embolism. Eur Heart J 2019;40:3453-5. [Crossref] [PubMed]
6. Comes RF, Mismetti P, Afshari A. European guidelines on perioperative venous thromboembolism prophylaxis: Inferior vena cava filters. Eur J Anaesthesiol 2018;35:108-11. [Crossref] [PubMed]
7. DeYoung E, Minocha J. Inferior Vena Cava Filters: Guidelines, Best Practice, and Expanding Indications. Semin Intervent Radiol 2016;33:65-70. [Crossref] [PubMed]
8. Bertoletti L, Girard P, Sanchez O. pour le groupe de travail Recommandations de bonne pratique pour la prise en charge de la MVTE. What are the indications for a caval filter? Rev Mal Respir 2021;38:e69-73. [Crossref] [PubMed]
9. PREPIC Study Group. Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC (Prevention du Risque d'Embolie Pulmonaire par Interruption Cave) randomized study. Circulation 2005;112:416-22. [Crossref] [PubMed]
10. Mismetti P, Laporte S, Pellerin O, Ennezat PV, Couturaud F, Elias A, et al. Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. JAMA 2015;313:1627-35. [Crossref] [PubMed]
11. Decousus H, Leizorovicz A, Parent F, Page Y, Tardy B, Girard P, Laporte S, Faivre R, Charbonnier B, Barral FG, Huet Y, Simonneau G. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prévention du Risque d'Embolie Pulmonaire par Interruption Cave Study Group. N Engl J Med 1998;338:409-15. [Crossref] [PubMed]
12. Muriel A, Jiménez D, Aujesky D, Bertoletti L, Decousus H, Laporte S, Mismetti P, Muñoz FJ, Yusen R, Monreal M. RIETE Investigators. Survival effects of inferior vena cava filter in patients with acute symptomatic venous thromboembolism and a significant bleeding risk. J Am Coll Cardiol 2014;63:1675-83. [Crossref] [PubMed]
13. Coombs C, Kuk D, Devlin S, Siegelbaum RH, Durack JC, Parameswaran R, Mantha S, Deng K, Soff G. Outcomes after inferior vena cava filter placement in cancer patients diagnosed with pulmonary embolism: risk for recurrent venous thromboembolism. J Thromb Thrombolysis 2017;44:489-93. [Crossref] [PubMed]
14. Stein PD, Matta F, Hughes MJ. Effectiveness of Inferior Vena Cava Filters in Patients With Stable and Unstable Pulmonary Embolism and Trends in Their Use. Am J Med 2020;133:323-30. [Crossref] [PubMed]
15. Bikdeli B, Chatterjee S, Desai NR, Kirtane AJ, Desai MM, Bracken MB, Spencer FA, Monreal M, Goldhaber SZ, Krumholz HM. Inferior Vena Cava Filters to Prevent Pulmonary Embolism: Systematic Review and Meta-Analysis. J Am Coll Cardiol 2017;70:1587-97. [Crossref] [PubMed]
16. Ayad MT, Gillespie DL. Long-term complications of inferior vena cava filters. J Vasc Surg Venous Lymphat Disord 2019;7:139-44. [Crossref] [PubMed]
17. Durack JC, Westphalen AC, Kekulawela S, Bhanu SB, Avrin DE, Gordon RL, Kerlan RK. Perforation of the IVC: rule rather than exception after longer indwelling times for the Günther Tulip and Celect retrievable filters. Cardiovasc Intervent Radiol 2012;35:299-308. [Crossref] [PubMed]
18. Al-Hakim R, Kee ST, Olinger K, Lee EW, Moriarty JM, McWilliams JP. Inferior vena cava filter retrieval: effectiveness and complications of routine and advanced techniques. J Vasc Interv Radiol 2014;25:933-9; quiz 940. [Crossref] [PubMed]
19. Angel LF, Tapson V, Galgon RE, Restrepo MI, Kaufman J. Systematic review of the use of retrievable inferior vena cava filters. J Vasc Interv Radiol 2011;22:1522-1530.e3. [Crossref] [PubMed]
20. Andreoli JM, Lewandowski RJ, Vogelzang RL, Ryu RK. Comparison of complication rates associated with permanent and retrievable inferior vena cava filters: a review of the MAUDE database. J Vasc Interv Radiol 2014;25:1181-5. [Crossref] [PubMed]
21. Desai TR, Morcos OC, Lind BB, Schindler N, Caprini JA, Hahn D, Warner D, Gupta N. Complications of indwelling retrievable versus permanent inferior vena cava filters. J Vasc Surg Venous Lymphat Disord 2014;2:166-73. [Crossref] [PubMed]
22. Zakhary EM, Elmore JR, Galt SW, Franklin DP. Optional filters in trauma patients: can retrieval rates be improved? Ann Vasc Surg 2008;22:627-34. [Crossref] [PubMed]
23. U.S. Food and Drug Administration. Removing Retrievable Inferior Vena Cava Filters: FDA Safety Communication. 2015 [cited 2024 Apr 8]. Available online: https://www.classlawgroup.com/wp-content/uploads/2015/07/IVC-2.pdf
24. Buso G, Alatri A, Calanca L, Fresa M, Qanadli SD, Pesavento R, Mazzolai L. Why optional inferior vena cava filters are not always retrieved? A real world 19 years experience in a Swiss tertiary care university hospital. Eur J Intern Med 2020;76:64-70. [Crossref] [PubMed]
25. Mismetti P, Rivron-Guillot K, Quenet S, Décousus H, Laporte S, Epinat M, Barral FG. A prospective long-term study of 220 patients with a retrievable vena cava filter for secondary prevention of venous thromboembolism. Chest 2007;131:223-9. [Crossref] [PubMed]
26. Peterson EA, Yenson PR, Liu D, Lee AY. Predictors of attempted inferior vena cava filters retrieval in a tertiary care centre. Thromb Res 2014;134:300-4. [Crossref] [PubMed]
27. Sarosiek S, Crowther M, Sloan JM. Indications, complications, and management of inferior vena cava filters: the experience in 952 patients at an academic hospital with a level I trauma center. JAMA Intern Med 2013;173:513-7. [Crossref] [PubMed]
28. Brown JD, Raissi D, Han Q, Adams VR, Talbert JC. Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort. J Am Heart Assoc 2017;6:e006708. [Crossref] [PubMed]
29. Ferro EG, Mackel JB, Kramer RD, Torguson R, Whatley EM, O'Connell G, Pullin B, Watson NW, Li S, Song Y, Krawisz AK, Carroll BJ, Schermerhorn ML, Weinstein JL, Farb A, Zuckerman B, Yeh RW, Secemsky EA. Postmarketing Surveillance of Inferior Vena Cava Filters Among US Medicare Beneficiaries: The SAFE-IVC Study. JAMA 2024;332:2091-100. [Crossref] [PubMed]
30. Dehbi S, Grange R, Poenou G, Ayoub E, Boutet C, Barral FG, Bertoletti L, Grange S. Temporary inferior vena cava filters factors associated with non-removal. Eur Radiol 2023;33:2585-92. [Crossref] [PubMed]
31. Ryu RK, Parikh P, Gupta R, Eifler AC, Salem R, Omary RA, Lewandowski RJ. Optimizing IVC filter utilization: a prospective study of the impact of interventional radiologist consultation. J Am Coll Radiol 2012;9:657-60. [Crossref] [PubMed]
32. Gasparis AP, Spentzouris G, Meisner RJ, Elitharp D, Labropoulos N, Tassiopoulos A. Improving retrieval rates of temporary inferior vena cava filters. J Vasc Surg 2011;54:34S-8S.e1.
33. Inagaki E, Farber A, Eslami MH, Siracuse JJ, Rybin DV, Sarosiek S, Sloan JM, Kalish J. Improving the retrieval rate of inferior vena cava filters with a multidisciplinary team approach. J Vasc Surg Venous Lymphat Disord 2016;4:276-82. [Crossref] [PubMed]
34. Minocha J, Idakoji I, Riaz A, Karp J, Gupta R, Chrisman HB, Salem R, Ryu RK, Lewandowski RJ. Improving inferior vena cava filter retrieval rates: impact of a dedicated inferior vena cava filter clinic. J Vasc Interv Radiol 2010;21:1847-51. [Crossref] [PubMed]
35. Sutphin PD, Reis SP, McKune A, Ravanzo M, Kalva SP, Pillai AK. Improving inferior vena cava filter retrieval rates with the define, measure, analyze, improve, control methodology. J Vasc Interv Radiol 2015;26:491-8.e1. [Crossref] [PubMed]
36. Everhart D, Vaccaro J, Worley K, Rogstad TL, Seleznick M. Retrospective analysis of outcomes following inferior vena cava (IVC) filter placement in a managed care population. J Thromb Thrombolysis 2017;44:179-89. [Crossref] [PubMed]
37. Lynch FC. A method for following patients with retrievable inferior vena cava filters: results and lessons learned from the first 1,100 patients. J Vasc Interv Radiol 2011;22:1507-12. [Crossref] [PubMed]