Utilization Patterns with Inferior Vena Cava Filters

Surgical versus Percutaneous Placement

Kenneth S. Crystal, Daniel J. Kase, Larry A. Scher, Michael A. Shapiro, James B. Naidich

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: To determine whether more inferior vena cava (IVC) filters were used after interventional radiologic placement methods became available, and if so, whether this increase could be due to expansion of indications. Patients and Methods: A retrospective analysis of the number of filters placed, the method of placement used, the indications for placement, and patient survival was performed during the 3 years before and the 3 years after 1989, the first year filters were placed percutaneously at the authors' institution. Results: From 1986 through 1988, 35 filters were all placed by surgeons in the operating room. From 1990 through 1992, 201 filters were all placed by radiologists in the special procedures suite. In the surgery group, 13 of 35 filters (37%) were placed for contraindications to anticoagulation therapy, 12 (34%) were placed for complications of anticoagulation, and nine (26%) were placed for recurrent thromboembolic disease despite anticoagulation. One filter was placed because of a free-floating thrombus in the IVC. In the radiology group, 98 of 161 patients (60%) underwent placement for contraindications to anticoagulation, 25 (16%) experienced complications of anticoagulation, 28 (17%) experienced recurrent thromboembolic disease, and nine (6%) had a free-floating thrombus. The 6-month survival in patients treated before 1989 was 80% versus 43% after 1989. Conclusion: At the authors' institution, filters are now placed exclusively by interventional radiologists. The overall indications for placement remain unchanged. The increase in utilization appears primarily related to more frequent placement in severely ill patients who may not experience considerably improved survival but may benefit from a substantial reduction in the risk of hemorrhagic complications.

Original languageEnglish (US)
Pages (from-to)443-448
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume6
Issue number3
DOIs
StatePublished - 1995
Externally publishedYes

Fingerprint

Vena Cava Filters
Survival
Thrombosis
Inferior Vena Cava
Operating Rooms
Risk Reduction Behavior
Radiology

Keywords

  • Interventional procedures, utilization, 982.1267
  • Venae cavae, filters, 982.1267
  • Venae cavae, thrombosis, 60.72, 982.1267

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Utilization Patterns with Inferior Vena Cava Filters : Surgical versus Percutaneous Placement. / Crystal, Kenneth S.; Kase, Daniel J.; Scher, Larry A.; Shapiro, Michael A.; Naidich, James B.

In: Journal of Vascular and Interventional Radiology, Vol. 6, No. 3, 1995, p. 443-448.

Research output: Contribution to journalArticle

Crystal, Kenneth S. ; Kase, Daniel J. ; Scher, Larry A. ; Shapiro, Michael A. ; Naidich, James B. / Utilization Patterns with Inferior Vena Cava Filters : Surgical versus Percutaneous Placement. In: Journal of Vascular and Interventional Radiology. 1995 ; Vol. 6, No. 3. pp. 443-448.
@article{43cf0f5f67a34838bad0df8662eb56f0,
title = "Utilization Patterns with Inferior Vena Cava Filters: Surgical versus Percutaneous Placement",
abstract = "Purpose: To determine whether more inferior vena cava (IVC) filters were used after interventional radiologic placement methods became available, and if so, whether this increase could be due to expansion of indications. Patients and Methods: A retrospective analysis of the number of filters placed, the method of placement used, the indications for placement, and patient survival was performed during the 3 years before and the 3 years after 1989, the first year filters were placed percutaneously at the authors' institution. Results: From 1986 through 1988, 35 filters were all placed by surgeons in the operating room. From 1990 through 1992, 201 filters were all placed by radiologists in the special procedures suite. In the surgery group, 13 of 35 filters (37{\%}) were placed for contraindications to anticoagulation therapy, 12 (34{\%}) were placed for complications of anticoagulation, and nine (26{\%}) were placed for recurrent thromboembolic disease despite anticoagulation. One filter was placed because of a free-floating thrombus in the IVC. In the radiology group, 98 of 161 patients (60{\%}) underwent placement for contraindications to anticoagulation, 25 (16{\%}) experienced complications of anticoagulation, 28 (17{\%}) experienced recurrent thromboembolic disease, and nine (6{\%}) had a free-floating thrombus. The 6-month survival in patients treated before 1989 was 80{\%} versus 43{\%} after 1989. Conclusion: At the authors' institution, filters are now placed exclusively by interventional radiologists. The overall indications for placement remain unchanged. The increase in utilization appears primarily related to more frequent placement in severely ill patients who may not experience considerably improved survival but may benefit from a substantial reduction in the risk of hemorrhagic complications.",
keywords = "Interventional procedures, utilization, 982.1267, Venae cavae, filters, 982.1267, Venae cavae, thrombosis, 60.72, 982.1267",
author = "Crystal, {Kenneth S.} and Kase, {Daniel J.} and Scher, {Larry A.} and Shapiro, {Michael A.} and Naidich, {James B.}",
year = "1995",
doi = "10.1016/S1051-0443(95)72839-1",
language = "English (US)",
volume = "6",
pages = "443--448",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Utilization Patterns with Inferior Vena Cava Filters

T2 - Surgical versus Percutaneous Placement

AU - Crystal, Kenneth S.

AU - Kase, Daniel J.

AU - Scher, Larry A.

AU - Shapiro, Michael A.

AU - Naidich, James B.

PY - 1995

Y1 - 1995

N2 - Purpose: To determine whether more inferior vena cava (IVC) filters were used after interventional radiologic placement methods became available, and if so, whether this increase could be due to expansion of indications. Patients and Methods: A retrospective analysis of the number of filters placed, the method of placement used, the indications for placement, and patient survival was performed during the 3 years before and the 3 years after 1989, the first year filters were placed percutaneously at the authors' institution. Results: From 1986 through 1988, 35 filters were all placed by surgeons in the operating room. From 1990 through 1992, 201 filters were all placed by radiologists in the special procedures suite. In the surgery group, 13 of 35 filters (37%) were placed for contraindications to anticoagulation therapy, 12 (34%) were placed for complications of anticoagulation, and nine (26%) were placed for recurrent thromboembolic disease despite anticoagulation. One filter was placed because of a free-floating thrombus in the IVC. In the radiology group, 98 of 161 patients (60%) underwent placement for contraindications to anticoagulation, 25 (16%) experienced complications of anticoagulation, 28 (17%) experienced recurrent thromboembolic disease, and nine (6%) had a free-floating thrombus. The 6-month survival in patients treated before 1989 was 80% versus 43% after 1989. Conclusion: At the authors' institution, filters are now placed exclusively by interventional radiologists. The overall indications for placement remain unchanged. The increase in utilization appears primarily related to more frequent placement in severely ill patients who may not experience considerably improved survival but may benefit from a substantial reduction in the risk of hemorrhagic complications.

AB - Purpose: To determine whether more inferior vena cava (IVC) filters were used after interventional radiologic placement methods became available, and if so, whether this increase could be due to expansion of indications. Patients and Methods: A retrospective analysis of the number of filters placed, the method of placement used, the indications for placement, and patient survival was performed during the 3 years before and the 3 years after 1989, the first year filters were placed percutaneously at the authors' institution. Results: From 1986 through 1988, 35 filters were all placed by surgeons in the operating room. From 1990 through 1992, 201 filters were all placed by radiologists in the special procedures suite. In the surgery group, 13 of 35 filters (37%) were placed for contraindications to anticoagulation therapy, 12 (34%) were placed for complications of anticoagulation, and nine (26%) were placed for recurrent thromboembolic disease despite anticoagulation. One filter was placed because of a free-floating thrombus in the IVC. In the radiology group, 98 of 161 patients (60%) underwent placement for contraindications to anticoagulation, 25 (16%) experienced complications of anticoagulation, 28 (17%) experienced recurrent thromboembolic disease, and nine (6%) had a free-floating thrombus. The 6-month survival in patients treated before 1989 was 80% versus 43% after 1989. Conclusion: At the authors' institution, filters are now placed exclusively by interventional radiologists. The overall indications for placement remain unchanged. The increase in utilization appears primarily related to more frequent placement in severely ill patients who may not experience considerably improved survival but may benefit from a substantial reduction in the risk of hemorrhagic complications.

KW - Interventional procedures, utilization, 982.1267

KW - Venae cavae, filters, 982.1267

KW - Venae cavae, thrombosis, 60.72, 982.1267

UR - http://www.scopus.com/inward/record.url?scp=0029298302&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029298302&partnerID=8YFLogxK

U2 - 10.1016/S1051-0443(95)72839-1

DO - 10.1016/S1051-0443(95)72839-1

M3 - Article

VL - 6

SP - 443

EP - 448

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 3

ER -