SIR Publishes Study on Patient Follow-Up After IVC Filter Placement

November 28, 2011—The Society of Interventional Radiology (SIR) announced the publication of the largest single-institution patient population study to date analyzing a method for following patients with retrievable inferior vena cava (IVC) filters. Frank C. Lynch, MD, published “A Method for Following Patients With Retrievable Inferior Vena Cava Filters: Results and Lessons Learned From the First 1,100 Patients” in SIR's Journal of Vascular and Interventional Radiology (2011;22:1507–1512). The study illustrates the importance of adherence to a strategy that continues to monitor patients and may provide a way to avoid long-term complications of filter placement, stated SIR.

“Results from this IVC filter study reinforce SIR's existing guidelines surrounding either successful retrieval or permanent placement,” commented SIR President Timothy P. Murphy, MD. “SIR knows that this is an important and vigorously debated issue. This research—an important addition to the IVC filter discussion—supports the call for continued rigorous patient/doctor communication and detailed data collection throughout the process, especially after filter placement in order for there to be success. Research like this may also provide a framework that doctors can use to guide practice and treat patients safely.”

In an invited commentary in the Journal of Vascular and Interventional Radiology, Charles E. Ray Jr, MD, stated, “Because retrievable filters may need to be removed within 4 to 6 weeks of placement, after which they may become too firmly attached to the IVC to be removable, it is important that individuals remain in contact with their physicians during that time to discuss the filter's possible removal. The primary barriers to filter removal remain those of patient selection and losing touch during the important period of follow-up. The degree of dedication brought to this study resulted in an amazingly low number of subjects lost to follow-up.”

SIR noted that IVC filters are a treatment option for patients who cannot take blood-thinning drugs or who develop clots despite medication and remain at risk for pulmonary embolism, which the US Surgeon General estimates is the cause of 100,000 to 180,000 deaths each year. Additionally, the US Food and Drug Administration (FDA) has stated that the use of IVC filters has grown from approximately 167,000 in 2007 to a projected 259,000 in 2012, with the majority of these devices intended for permanent placement.

According to SIR, the FDA has recognized that some retrievable IVC filters can fracture or migrate to other parts of the bloodstream and has urged doctors who implant filters to regularly consider the risk/benefit profile for each individual patient and to give strong consideration to removing these devices from patients who may no longer be at increased risk of pulmonary embolism. SIR advised that its guidelines for IVC filter placement and clinical care, as well as IVC quality improvement guidelines, closely parallel current FDA recommendations.