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SIR 2025

Venous Interventions

Scientific Session

Session: Transplant Interventions

Thrombosis Risk and Breakthrough Pulmonary Embolism in Cancer Patients with Inferior Vena Cava Filters and Impact of Mechanical Thrombectomy in Patient Outcomes: A Single-Center Retrospective Analysis of 1,594 patients

Tuesday, April 1, 2025
4:21 PM – 4:30 PM CT
Location: Music City Center, 202 A
Purpose:  To evaluate the rates of breakthrough pulmonary embolism and IVC filter thrombosis in cancer patients and study the impact of treating IVC filter thrombosis with mechanical thrombectomy on overall cancer patient outcomes and survival. 

Materials and Methods: This single-center retrospective study evaluated outcomes following IVC filter placement in cancer patients. Records were collected from the electronic medical record for cancer patients who underwent IVC filter placement between January 2016 to July 2023. Post-placement CT scans were evaluated for thrombosis within the IVC filter as well as interventions.  

Results: 1,595 patients who underwent 1,633 IVC filter placement procedures were included. The median age was 64 (range: 18-96). 713 patients were female(45%), while 882 were male(55%). A diverse range of 14 cancer types was represented in the study population. The median follow-up time was 160 days (range 1-2782 days), and the median overall survival(OS) was 150 days. 1,633 IVC filters were placed, the majority of which were Option Elite(1,024, 63%), followed by Venatech (351, 21%), Cook(211, 13%), and ALN (40,2.4%). The filter retrieval rate was 23.5% of retrievable filters. The rate of breakthrough pulmonary embolism was 2.4%(38/1595). The IVC filter thrombosis rate was 5.6% (90/1595). There was a significant difference in the OS in patients with thrombosed IVC filters versus those without thrombosis (p< 0.0001). Furthermore, of the 90 thrombosed filters, there was a significant difference in OS in patients who received thrombectomy(n=23) versus those who did not(n=67)(p=.0074). Competing risks regression for breakthrough pulmonary embolism demonstrated that IVC filter thrombosis (HR 5.38), male gender (HR 2.52), and ALN filters (5.13) were significant predictors of breakthrough PE.   

Conclusion: IVC filter placement is safe and efficacious in preventing pulmonary embolism. However, the rates of IVC thrombosis in cancer patients are higher than in other reported examinations, which may contribute to increased mortality in cancer patients. Additionally, data suggests that mechanical thrombectomy in cancer patients presenting with IVC filter associated DVT could result in improved outcomes and patient survival.