High Accountability of Retrievable IVC Filters with an Actively Managed Prospective Patient Database over a 12-Year Period

Purpose: To evaluate retrievable inferior vena cava (IVC) filter outcomes with a prospectively maintained IVC filter database and active patient management by interventional radiology (IR).

Materials and Methods: Patients with retrievable IVC filters placed by IR from 2012 to 2023 at a single, tertiary institution were tracked in a prospective registry, and follow-up was organized by a designated IR physician assistant. Patients were contacted by phone, or by letter if unable to be reached by phone, after the filter was placed by IR; then, an IR clinic visit and any necessary imaging was arranged to discuss filter removal if deemed appropriate. Retrospective review of filter outcomes, including retrieval, patient death, and need for permanent filter placement was performed.

Results: Over the 12-year study period, 608 retrievable IVC filters were placed: 516 Denali, 63 Bard Eclipse, 20 Günther Tulip, and 9 Cook Celect Platinum. In total, 42% (256) were retrieved with 100% success in retrieval attempts; 7% (44) were adjudicated to be permanent; and 46% (282) died with the filter in place. The remaining 4% (26) comprise patients who are alive with the filter not yet retrieved at the study endpoint, 54% (14/26) of which were placed in 2023. Of this cohort, 42% (11/26) still need the filter and are being monitored to determine follow-up timing, and 38% (10/26) are pending follow-up; overall 0.8% (5/608) have been sent a final letter due to repeated no-shows and/or inability to reach the patient via phone or mail despite multiple attempts.

Conclusion: This study demonstrates a high percentage (99.2%) of retrievable IVC filters have been accounted for using a prospective patient registry actively managed by an IR PA. This system suggests an effective and feasible model for tracking patients with retrievable IVC filters to facilitate appropriate follow-up.