Rahil H Kassamali1, Kateryna Burlak2, Jonathan T L Lee2, Georgina Aberdein2, George Harisis2, Gerard S Goh2,3, Helen Kavnoudias2,3, Warren Clements4,5. 1. Department of Radiology, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. 2. Department of Radiology, Alfred Health, Alfred Hospital, 55 Commercial Road, Melbourne, VIC, 3004, Australia. 3. Department of Surgery, Monash University, Melbourne, Australia. 4. Department of Radiology, Alfred Health, Alfred Hospital, 55 Commercial Road, Melbourne, VIC, 3004, Australia. w.clements@alfred.org.au. 5. Department of Surgery, Monash University, Melbourne, Australia. w.clements@alfred.org.au.
Abstract
PURPOSE: Assess the safety of inferior vena cava (IVC) filter retrieval in patients taking anticoagulation, compared to a non-anticoagulated cohort. MATERIALS AND METHODS: Single-centre retrospective analysis of patients who underwent IVC filter retrieval between January 2012 and February 2018. Information about patient demographics, anticoagulation, tilt, major and minor complications was collected. Major complications were defined as: IVC injury from the filter retrieval, retained fragment of filter, filter fracture and filter embolisation. Minor complications were defined as: neck haematoma and puncture site infection. RESULTS: Total of 357 patients (age 18-95, Male: 231) underwent IVC filter retrieval, comprising of Cook Celect Platinum, Cook Celect, and ALN-branded filters. Of these 182 patients were on anticoagulation and 175 patients were not on anticoagulation, based on the indication for the filter (thrombosis or prophylaxis) and at the discretion of the referring unit who were managing the anticoagulation. IVC filter retrieval was technically successful in 349 patients. Five major complications (1.4% of retrievals) were recorded and no minor complications (0% of retrievals). In the anticoagulation cohort, there were two major complications (1.1% of retrievals) both related to IVC injury. In the non-anticoagulated cohort, there were three major complications (1.7% of retrievals) relating to filter embolisation, IVC injury, and filter fracture. CONCLUSIONS: IVC filter retrieval is a safe procedure with a low complication rate. Being on anticoagulation does not increase the risk of a major complication or change the management of major complication compared with a non-anticoagulated cohort. IVC filter retrieval is safe to perform in patients currently taking prophylactic or therapeutic anticoagulation based on our cohort. LEVEL OF EVIDENCE: Level 3, retrospective cohort study.
PURPOSE: Assess the safety of inferior vena cava (IVC) filter retrieval in patients taking anticoagulation, compared to a non-anticoagulated cohort. MATERIALS AND METHODS: Single-centre retrospective analysis of patients who underwent IVC filter retrieval between January 2012 and February 2018. Information about patient demographics, anticoagulation, tilt, major and minor complications was collected. Major complications were defined as: IVC injury from the filter retrieval, retained fragment of filter, filter fracture and filter embolisation. Minor complications were defined as: neck haematoma and puncture site infection. RESULTS: Total of 357 patients (age 18-95, Male: 231) underwent IVC filter retrieval, comprising of Cook Celect Platinum, Cook Celect, and ALN-branded filters. Of these 182 patients were on anticoagulation and 175 patients were not on anticoagulation, based on the indication for the filter (thrombosis or prophylaxis) and at the discretion of the referring unit who were managing the anticoagulation. IVC filter retrieval was technically successful in 349 patients. Five major complications (1.4% of retrievals) were recorded and no minor complications (0% of retrievals). In the anticoagulation cohort, there were two major complications (1.1% of retrievals) both related to IVC injury. In the non-anticoagulated cohort, there were three major complications (1.7% of retrievals) relating to filter embolisation, IVC injury, and filter fracture. CONCLUSIONS: IVC filter retrieval is a safe procedure with a low complication rate. Being on anticoagulation does not increase the risk of a major complication or change the management of major complication compared with a non-anticoagulated cohort. IVC filter retrieval is safe to perform in patients currently taking prophylactic or therapeutic anticoagulation based on our cohort. LEVEL OF EVIDENCE: Level 3, retrospective cohort study.
Authors: Miguel A De Gregorio; Jose A Guirola; Sergio Sierre; Jose Urbano; Juan Jose Ciampi-Dopazo; Jose M Abadal; Juan Pulido; Eduardo Eyheremendy; Elena Lonjedo; Guadalupe Guerrero; Carolina Serrano-Casorran; Pedro Pardo; Micaela Arrieta; Jose Rodriguez-Gomez; Cristina Bonastre; George Behrens; Carlos Lanciego; Hector Ferral; Mariano Magallanes; Santiago Mendez; Mercedes Perez; Jimena Gonzalez-Nieto; William T Kuo; David Jimenez Journal: J Clin Med Date: 2021-12-24 Impact factor: 4.241