Study Evaluates Rising IVC Filter Retrieval Rates in the United States

April 4, 2018—Osman Ahmed, MD, et al conducted a study that sought to determine recent inferior vena cava (IVC) filter retrieval volumes and rates in the United States Medicare population. The findings were published online in Journal of the American College of Radiology (JACR).

The investigators concluded that since the introduction of the unique Healthcare Common Procedure Coding System code for IVC filter retrieval in 2012, IVC filter placements in the Medicare population have been declining and net retrieval rates have risen. Additionally, radiologists continue to place and retrieve the majority of filters.

For the study, the investigators searched summary Medicare claims data for the years 2012 to 2016 to identify the frequency of IVC filter placements and retrievals. To track filter retrievals, they used the new Healthcare Common Procedure Coding System code for filter retrieval (37193) that was introduced in 2012. Trends in the number of IVC filter placements and retrievals over the study period were evaluated, both of which were further stratified by physician specialty and site of service. Aggregate and compound annual growth rates for retrievals were also computed.

As summarized in JACR, a total of 255,034 filters were placed during the study period, with the filter placement volume declining from 61,889 in 2012 to 38,095 in 2016. Filter retrievals, however, increased from 4,327 in 2012 to 8,405 in 2016. The net filter retrieval rate per annual filters placed increased from 6.9% in 2012 to 22.1% in 2016, yielding an average filter retrieval rate and compound annual growth rate of 11.6% and 18.1%, respectively.

Radiologists placed and retrieved the majority of filters (60.4% placed, 63.5% retrieved) compared with nonradiologists. The inpatient setting was the dominant site for filter placement compared with the outpatient setting for filter retrieval across all years and specialties, reported the investigators in JACR.

Discussing the findings with Endovascular Today, the study's lead investigators, Osman Ahmed, MD, and Vibhor Wadhwa, MD, commented, "Declining national IVC filter utilization is a well-documented phenomenon since the US Food and Drug Administration issued its safety advisory regarding the long-term risks of caval filtration in 2010. This finding is complemented by the results of our study demonstrating that IVC filter retrievals are concurrently increasing over the past 4 years. We are encouraged based on our study that radiologists along with other endovascular specialists are taking a primary role in the follow-up of patients with IVC filters to ensure appropriate removal."