Safety and Outcomes of Permanent and Retrievable Inferior Vena Cava Filters in the Oncology Population
Background. The role for inferior vena cava (IVC) filters in the oncology population is poorly defined. Objectives. Our primary endpoint was to determine the rate of filter placement in cancer patients without an absolute contraindication to anticoagulation and the rate of recurrent VTE after filter...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | International Journal of Vascular Medicine |
| Online Access: | http://dx.doi.org/10.1155/2020/6582742 |
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| author | Saba S. Shaikh Suneel D. Kamath Debashis Ghosh Robert J. Lewandowski Brandon J. McMahon |
| author_facet | Saba S. Shaikh Suneel D. Kamath Debashis Ghosh Robert J. Lewandowski Brandon J. McMahon |
| author_sort | Saba S. Shaikh |
| collection | DOAJ |
| description | Background. The role for inferior vena cava (IVC) filters in the oncology population is poorly defined. Objectives. Our primary endpoint was to determine the rate of filter placement in cancer patients without an absolute contraindication to anticoagulation and the rate of recurrent VTE after filter placement in both retrievable and permanent filter groups. Patients/Methods. A single-institution, retrospective study of patients with active malignancies and acute VTE who received a retrievable or permanent IVC filter between 2009-2013. Demographics and outcomes were confirmed on independent chart review. Cost data were obtained using Current Procedural Terminology (CPT) codes. Results. 179 patients with retrievable filters and 207 patients with permanent filters were included. Contraindication to anticoagulation was the most cited reason for filter placement; however, only 76% of patients with retrievable filters and 69% of patients with permanent filters had an absolute contraindication to anticoagulation. 20% of patients with retrievable filters and 24% of patients with permanent filters had recurrent VTE. The median time from filter placement to death was 8.9 and 3.2 months in the retrievable and permanent filter groups, respectively. The total cost of retrievable filters and permanent filters was $2,883,389 and $3,722,688, respectively. Conclusions. The role for IVC filters in cancer patients remains unclear as recurrent VTE is common and time from filter placement to death is short. Filter placement is costly and has a clinically significant complication rate, especially for retrievable filters. More data from prospective, randomized trials are needed to determine the utility of IVC filters in cancer patients. |
| format | Article |
| id | doaj-art-dc731e9ed89d47de90a737e261caea91 |
| institution | Kabale University |
| issn | 2090-2824 2090-2832 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Vascular Medicine |
| spelling | doaj-art-dc731e9ed89d47de90a737e261caea912025-02-03T01:05:28ZengWileyInternational Journal of Vascular Medicine2090-28242090-28322020-01-01202010.1155/2020/65827426582742Safety and Outcomes of Permanent and Retrievable Inferior Vena Cava Filters in the Oncology PopulationSaba S. Shaikh0Suneel D. Kamath1Debashis Ghosh2Robert J. Lewandowski3Brandon J. McMahon4Northwestern University Feinberg School of Medicine, Department of Medicine, Chicago, IL 60611, USANorthwestern University Feinberg School of Medicine, Department of Medicine, Division of Hematology/Oncology, USAUniversity of Colorado School of Public Health, Department of Biostatistics and Informatics, USANorthwestern University Feinberg School of Medicine, Department of Medicine, Division of Hematology/Oncology, USAUniversity of Colorado School of Medicine, Department of Medicine, Division of Hematology, USABackground. The role for inferior vena cava (IVC) filters in the oncology population is poorly defined. Objectives. Our primary endpoint was to determine the rate of filter placement in cancer patients without an absolute contraindication to anticoagulation and the rate of recurrent VTE after filter placement in both retrievable and permanent filter groups. Patients/Methods. A single-institution, retrospective study of patients with active malignancies and acute VTE who received a retrievable or permanent IVC filter between 2009-2013. Demographics and outcomes were confirmed on independent chart review. Cost data were obtained using Current Procedural Terminology (CPT) codes. Results. 179 patients with retrievable filters and 207 patients with permanent filters were included. Contraindication to anticoagulation was the most cited reason for filter placement; however, only 76% of patients with retrievable filters and 69% of patients with permanent filters had an absolute contraindication to anticoagulation. 20% of patients with retrievable filters and 24% of patients with permanent filters had recurrent VTE. The median time from filter placement to death was 8.9 and 3.2 months in the retrievable and permanent filter groups, respectively. The total cost of retrievable filters and permanent filters was $2,883,389 and $3,722,688, respectively. Conclusions. The role for IVC filters in cancer patients remains unclear as recurrent VTE is common and time from filter placement to death is short. Filter placement is costly and has a clinically significant complication rate, especially for retrievable filters. More data from prospective, randomized trials are needed to determine the utility of IVC filters in cancer patients.http://dx.doi.org/10.1155/2020/6582742 |
| spellingShingle | Saba S. Shaikh Suneel D. Kamath Debashis Ghosh Robert J. Lewandowski Brandon J. McMahon Safety and Outcomes of Permanent and Retrievable Inferior Vena Cava Filters in the Oncology Population International Journal of Vascular Medicine |
| title | Safety and Outcomes of Permanent and Retrievable Inferior Vena Cava Filters in the Oncology Population |
| title_full | Safety and Outcomes of Permanent and Retrievable Inferior Vena Cava Filters in the Oncology Population |
| title_fullStr | Safety and Outcomes of Permanent and Retrievable Inferior Vena Cava Filters in the Oncology Population |
| title_full_unstemmed | Safety and Outcomes of Permanent and Retrievable Inferior Vena Cava Filters in the Oncology Population |
| title_short | Safety and Outcomes of Permanent and Retrievable Inferior Vena Cava Filters in the Oncology Population |
| title_sort | safety and outcomes of permanent and retrievable inferior vena cava filters in the oncology population |
| url | http://dx.doi.org/10.1155/2020/6582742 |
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