Background: Inferior vena cava filters (IVCF) are commonly used to prevent pulmonary embolism in high risk patients deemed unsuitable for venous thromboembolism (VTE) chemoprophylaxis, or as adjunct therapy in patients with established VTE who are unable to receive anticoagulation due to high bleeding risk. However, insertion of IVCF may result in significant complications such as IVC occlusion or filter embolisation. Therefore, timely filter retrieval is critical.
Aims: To evaluate whether the introduction of a multidisciplinary surveillance team (MDST) impacts IVCF retrieval rate, time-to-retrieval, filter-related complications, and rate of VTE after IVCF insertion.
Methods: Retrospective study at a tertiary institution evaluating all patients with IVCF insertion between January 2015 and December 2018. A MDST, involving haematology and pharmacy, was introduced in July 2017. The team had oversight of all patients with IVCF inserted and established systematic follow up and planning for filter retrieval. All patients were followed up to 12 months after IVCF insertion. Outcomes were compared between the groups before (pre-MDST) and after (post-MDST) introducing the MDST.
Results: Four hundred and sixty-six patients had retrievable IVCF inserted, with 280 patients in the pre-MDST group and 186 patients in the post-MDST group. Overall, 208 (44.6%) patients received an IVCF due to acute VTE, and 258 (55.4%) patients received the filter as VTE prophylaxis. After the introduction of a MDST, the rate of successful IVCF retrieval was significantly increased from 51.1% to 71.5% (p<0.0001), and patients lost-to-follow-up decreased from 18.9% to 3.8% (p<0.0001) (Table 1). No significant differences between the pre-MDST and post-MDST groups were found in time-to-retrieval, filter complications, or VTE after IVCF insertion.
Summary of results
Conclusions: The establishment of an MDST for IVCF resulted in a significant improvement in filter retrieval rates and notable reduction in patients lost-to-follow-up. These findings support the implementation of a supervisory team to improve IVCF monitoring and retrieval to improve patient-centred care.
To cite this abstract in AMA style:
Chao S, Bortz H, Stevens H, McFadyen J, Tran H. Implementation of a Multidisciplinary Surveillance Team to Improve Inferior Vena Cava Filter Retrieval and Outcomes [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/implementation-of-a-multidisciplinary-surveillance-team-to-improve-inferior-vena-cava-filter-retrieval-and-outcomes/. Accessed September 24, 2021.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/implementation-of-a-multidisciplinary-surveillance-team-to-improve-inferior-vena-cava-filter-retrieval-and-outcomes/