• Eric Irwin, Matthew Byrnes, Scott Schultz, Jeffrey Chipman, Alan Beal, Mark Ahrendt, Greg Beilman, and J Kevin Croston.
• Division of Trauma, Department of Surgery, North Memorial Trauma Institute, North Memorial Medical Center, Robbinsdale, Minnesota, USA. ericdirwin@yahoo.com
• J Trauma. 2010 Oct 1; 69 (4): 866-9.

BackgroundRetrievable inferior vena cava filters (rIVCF) reduce the short-term risk of pulmonary embolism without the filter and inferior vena cava (IVC) thrombosis that have been reported with the use of permanent filters. Studies have shown that most rIVCFs are not removed, leaving patients at risk for thrombotic complications of rIVCF retention. We hypothesize that the application of a systematic follow-up for rIVCF will improve filter removal rates, providing patients short-term prophylaxis from pulmonary embolism whereas avoiding complications of permanent filter retention.MethodsThe trauma registry of a Level I trauma center was queried to identify patients who underwent placement of IVCFs between January 1, 2003, and June 30, 2008. The medical records were reviewed and details of the patient's injuries, indications for filter placement, repositioning, and retrieval were collected. Radiographic images were reviewed to confirm ultimate filter retention or removal.ResultsBetween January 1, 2003, and June 30, 2008, rIVCFs were placed in 118 patients, 44% had known venous thromboembolic event. Three patients died before rIVCFs could be considered for extraction, leaving 115 patients for evaluation. Filters were removed in 80 patients (70%) overall. Of the 35 patients in whom filters were not removed, 11 were lost to follow-up, 4 failed removal attempts, and 20 had indications for filter retention. The rIVCFs were retrieved in 75% of patients not lost to follow-up and 92% of patients who did not have contraindications for filter removal.ConclusionA dedicated system for following-up patients with rIVCFs markedly improves removal rates of retrievable filters.

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