REGULAR CONTENT
Final ID
644
Type
Educational Exhibit-Poster Only
Authors
S Bahl1, C Hua1, N Koney1, V Bishay2, M Syed2, R Dreifuss2, A Friedman2, E Kim2, R Lookstein2, F Nowakowski2, R Patel2, N Tabori2, A Fischman2
Institutions
1Mount Sinai West-St. Luke's Hospital, New York, NY, 2Icahn School of Medicine at Mount Sinai, New York, NY
Purpose
1. Indications for an IVC filter2. Complications of an IVC filter3. Latest FDA recommendations for retrieval4. How to design an IVC filter retrieval clinic
Materials & Methods
IVC filters (IVCF) protect against PE, but not without complication risks, including IVCF fracture, strut penetration, and migration. The majority of IVCF placed today are retrievable, although the majority of patients are lost to follow-up. In 2014, the FDA referred to a model suggesting that if the patient's transient risk for PE has passed, the risk/benefit profile begins to favor removal of the filter between 29 and 54 days after implantation. An IVCF retrieval clinic may be an effective means to ensure adequate follow-up and potential removal of IVCF that are no longer needed.
Results
A trainee-run IVCF retrieval clinic is proposed to establish a baseline retrieval rate and demonstrate the effectiveness of the protocol. Control group: 6 months of patients with IVCF, who will undergo current management.Retrospective group: Comprises a subsequent 6 months of patients. The resident team will send letters to the patient and PMD, advising IR follow-up.Prospective group: Inpatients receiving an IVCF, who will have a letter and refrigerator magnet, supplied by the device manufacturer, placed on their chart. The assisting resident or fellow will use a macro in their dictation and post-procedure note, advising the ordering physician for IR follow-up after discharge. The plan is for a 6-week post-IVCF placement appointment (within the FDA's referral to 29-54 days). A 6-week follow-up letter will be sent to the patient and PMD by the IR PA, as a reminder.The clinic will be staffed by residents and fellows, who will assist in determining eligibility. If eligible, the patient will be booked for IVCF retrieval.
Conclusions
The updated FDA statement is a useful guide in IVCF management. An organized trainee-run clinic could be a strong resident/fellow learning tool in clinical management and quality improvement. Research has shown that an IVCF retrieval clinic facilitates an increase in retrieval rate and an increase in revenue. Added benefits may include IR's greater ownership of patient care and more referrals.
Final ID
644
Type
Educational Exhibit-Poster Only
Authors
S Bahl1, C Hua1, N Koney1, V Bishay2, M Syed2, R Dreifuss2, A Friedman2, E Kim2, R Lookstein2, F Nowakowski2, R Patel2, N Tabori2, A Fischman2
Institutions
1Mount Sinai West-St. Luke's Hospital, New York, NY, 2Icahn School of Medicine at Mount Sinai, New York, NY
Purpose
1. Indications for an IVC filter2. Complications of an IVC filter3. Latest FDA recommendations for retrieval4. How to design an IVC filter retrieval clinic
Materials & Methods
IVC filters (IVCF) protect against PE, but not without complication risks, including IVCF fracture, strut penetration, and migration. The majority of IVCF placed today are retrievable, although the majority of patients are lost to follow-up. In 2014, the FDA referred to a model suggesting that if the patient's transient risk for PE has passed, the risk/benefit profile begins to favor removal of the filter between 29 and 54 days after implantation. An IVCF retrieval clinic may be an effective means to ensure adequate follow-up and potential removal of IVCF that are no longer needed.
Results
A trainee-run IVCF retrieval clinic is proposed to establish a baseline retrieval rate and demonstrate the effectiveness of the protocol. Control group: 6 months of patients with IVCF, who will undergo current management.Retrospective group: Comprises a subsequent 6 months of patients. The resident team will send letters to the patient and PMD, advising IR follow-up.Prospective group: Inpatients receiving an IVCF, who will have a letter and refrigerator magnet, supplied by the device manufacturer, placed on their chart. The assisting resident or fellow will use a macro in their dictation and post-procedure note, advising the ordering physician for IR follow-up after discharge. The plan is for a 6-week post-IVCF placement appointment (within the FDA's referral to 29-54 days). A 6-week follow-up letter will be sent to the patient and PMD by the IR PA, as a reminder.The clinic will be staffed by residents and fellows, who will assist in determining eligibility. If eligible, the patient will be booked for IVCF retrieval.
Conclusions
The updated FDA statement is a useful guide in IVCF management. An organized trainee-run clinic could be a strong resident/fellow learning tool in clinical management and quality improvement. Research has shown that an IVCF retrieval clinic facilitates an increase in retrieval rate and an increase in revenue. Added benefits may include IR's greater ownership of patient care and more referrals.