Vol. 51 | No. 2 | July-December 2023 Back

Open Access

Indications and Outcomes of Inferior Vena Cava Filter Insertion in a Tertiary Hospital in Metro Manila, Philippines: A Retrospective Cohort Study

Ma. Krizia Camille Yap-Uy, Lester Uy, Ramayana Diaz-Garcia
Dec 2023 DOI 10.69944/pjc.134f14e15a

Abstract

INTRODUCTION: Inferior vena cava (IVC) filters entrap emboli from the periphery going to the pulmonary circulation, preventing pulmonary embolism (PE). Studies show that many IVC filter insertions are done for weak or non–guideline-directed indications. This study examined the indications for IVC filter insertion in a tertiary care hospital in Metro Manila, adherence to society guidelines, and clinical outcomes after filter insertion.

METHODS: This study is a retrospective cohort involving patients who received an IVC filter from January 2015 to February 2021. The main outcome was the indication for IVC filter. Other outcomes were strength of recommendation for filter placement and postfilter clinical outcomes: all-cause death, venous thromboembolism–related mortality, PE, and filter-related complications.

RESULTS: Eighty-three patients received IVC filters from January 2015 to February 2021, and 77 were included in the analysis. Sixty-one percent had moderate to strong indications for the procedure, 49% were due to contraindication to anticoagulation. Thirty-nine percent had unclear indications: 16% concomitantly received therapeutic anticoagulation, whereas 11% had isolated distal deep vein thrombosis. Mean follow-up was 170 days. Postfilter clinical outcomes included all-cause death in 12%, venous thromboembolism–related mortality in 1%, and PE in 3%. Filter complications occurred in 4%. Retrievable IVC filters were used in 51% with attempted removal in 4%, 3% of which were successful.

CONCLUSION: The majority of patients receiving IVC filters in our center had strong to moderate indications for the procedure. The use of retrievable filters and consequent retrieval is low and should be encouraged. Venous thromboembolism–related mortality and filter complications were low, comparable to international data.

KEYWORDS: echocardiography, laboratory, reader, resources, sonographer, survey

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