Outcomes of retrievable inferior vena cava filters in patients with deep vein thrombosis and transient contraindication for anticoagulation

ABSTRACT

PURPOSE: To determine the efficacy of a retrievable inferior vena cava filter (IVCF) for patients with deep vein thrombosis (DVT) and transient contraindication for anticoagulant therapy, and to analyze the risk factors for filter thrombus in these patients. METHODS: We retrospectively reviewed the records of 70 patients who received a retrievable IVCF from January 2007 to June 2014 because of documented DVT and transient contraindication for anticoagulant therapy. The protocol for follow-up care generally consisted of anticoagulant therapy after high-risk periods, follow-up CT around 2 weeks after IVCF placement, and retrieval if possible. RESULTS: The 70 patients had a mean age of 61.8 years (range, 17-88 years), and 30 were male (43%). The indications for IVCF were recent trauma including surgery in 48 patients, recent hemorrhage in 14, and planned major surgery with DVT in 8 patients. Follow-up CT of 61 patients (87%) was performed. Aggravation or new development of pulmonary embolism (PE) was not found in any patient. Filter thrombus was detected in 23% of patients with follow-up CT (14/61). Filter thrombus was not detected in patients with isolated calf vein thrombosis (ICVT) (P = 0.079). The risk factor for filter thrombus was DVT progression on follow-up CT (P = 0.007) on multivariate analysis. CONCLUSION: For patients with DVT and transient contraindication for anticoagulant therapy, a retrievable IVCF could prevent the aggravation or new development of PE. DVT progression on follow-up CT was associated with filter thrombus and ICVT was not related to filter thrombus in the present study.