REGULAR CONTENT
Final ID
570
Type
Original Scientific Research-Oral or Pos
Authors
J Laws1, R Lewandowski1, R Salem1, J Karp2, K Desai1
Institutions
1Northwestern University, Chicago, IL, 2Northwestern Memorial Hospital, Chicago, IL
Purpose
Retrievable IVC filters (rIVCF) are subject to greater rates of device-related adverse events (AEs) relative to permanent devices; the risk of these AEs increases with filter dwell time. However, retrieval of rIVCF with prolonged dwell time has been associated with higher risk of procedural AEs. We aim to compare the risk of AEs from retrieval procedures of rIVCF with >3 month implantation time to the risk of device-related AEs associated with indefinite placement of rIVCF.
Materials & Methods
With IRB approval, a prospectively acquired single center rIVCF retrieval database (1/2009-8/2016) was reviewed. Retrievable devices with >3 month implantation time were included in the analysis. We reviewed demographics, dwell time, and procedural AEs (filter fracture, access site bleeding, post-removal extravasation). Data for AEs from >3 month dwell rIVCF were collected and pooled by literature meta-analysis and included fracture, IVC penetration, thromboembolism, and IVC thrombus. Data was analyzed with mixed-effects logistical regression, populations were compared with by median 2 method. Significance accepted at p<0.05.
Results
A total of 379 retrieval procedures were performed at >3 month dwell time; 375 rIVCF were successfully retrieved (98.9%). There was no significant difference between retrieval cohort (mean age: 5316, 50.4% male, mean dwell time 25.640 months) and literature review cohort (n=1278, mean age 6011, 45% male, mean dwell time 21.16.3 months), p=0.9. Rates of AEs were higher in the indefinite implantation group (165/1278, 12.9%) compared to the retrieval procedure group (29/375, 7.73%). Retrievable devices with indefinite implantation were significantly more likely to cause adverse events compared to procedural-related complications of retrieval (OR 1.54, 95% CI 1.04-2.27, p=0.032).
Conclusions
There is an approximate 1.5-fold greater risk of AEs associated with leaving rIVCF in situ indefinitely, suggesting that rIVCF no longer indicated should be retrieved regardless of dwell time. This supports the 2014 FDA Safety Communication recommending rIVCF retrieval when no longer indicated.
Final ID
570
Type
Original Scientific Research-Oral or Pos
Authors
J Laws1, R Lewandowski1, R Salem1, J Karp2, K Desai1
Institutions
1Northwestern University, Chicago, IL, 2Northwestern Memorial Hospital, Chicago, IL
Purpose
Retrievable IVC filters (rIVCF) are subject to greater rates of device-related adverse events (AEs) relative to permanent devices; the risk of these AEs increases with filter dwell time. However, retrieval of rIVCF with prolonged dwell time has been associated with higher risk of procedural AEs. We aim to compare the risk of AEs from retrieval procedures of rIVCF with >3 month implantation time to the risk of device-related AEs associated with indefinite placement of rIVCF.
Materials & Methods
With IRB approval, a prospectively acquired single center rIVCF retrieval database (1/2009-8/2016) was reviewed. Retrievable devices with >3 month implantation time were included in the analysis. We reviewed demographics, dwell time, and procedural AEs (filter fracture, access site bleeding, post-removal extravasation). Data for AEs from >3 month dwell rIVCF were collected and pooled by literature meta-analysis and included fracture, IVC penetration, thromboembolism, and IVC thrombus. Data was analyzed with mixed-effects logistical regression, populations were compared with by median 2 method. Significance accepted at p<0.05.
Results
A total of 379 retrieval procedures were performed at >3 month dwell time; 375 rIVCF were successfully retrieved (98.9%). There was no significant difference between retrieval cohort (mean age: 5316, 50.4% male, mean dwell time 25.640 months) and literature review cohort (n=1278, mean age 6011, 45% male, mean dwell time 21.16.3 months), p=0.9. Rates of AEs were higher in the indefinite implantation group (165/1278, 12.9%) compared to the retrieval procedure group (29/375, 7.73%). Retrievable devices with indefinite implantation were significantly more likely to cause adverse events compared to procedural-related complications of retrieval (OR 1.54, 95% CI 1.04-2.27, p=0.032).
Conclusions
There is an approximate 1.5-fold greater risk of AEs associated with leaving rIVCF in situ indefinitely, suggesting that rIVCF no longer indicated should be retrieved regardless of dwell time. This supports the 2014 FDA Safety Communication recommending rIVCF retrieval when no longer indicated.