• Michael S Conners, Stacey Becker, Raul J Guzman, Marc A Passman, Rosanna Pierce, Tina Kelly, and Thomas C Naslund.
• Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-2725, USA.
• J. Vasc. Surg. 2002 Feb 1; 35 (2): 286-91.

PurposeThe purpose of this study was the assessment of the safety, efficacy, and hospital charges of bedside duplex ultrasound-directed inferior vena cava (IVC) filter placement.MethodsAll duplex ultrasound-directed IVC filters that were placed from August 8, 1995, to December 31, 2000, are reviewed. Chart review combined with mailed questionnaires and telephone follow-up examinations were used to collect demographic and outcome data.ResultsThree hundred twenty-five patients underwent evaluation, and 284 underwent duplex ultrasound-directed IVC filter placement. Two hundred three (71%) were male patients, and 81 (29%) were female patients. Poor IVC visualization, IVC thrombosis, and unsuitable anatomy prevented duplex-directed filter placement in 41 patients (12%). Indication for filter placement included venous prophylaxis in the absence of thromboembolism in 235 patients (83%), contraindication to anticoagulation therapy in 34 patients (12%), prophylaxis with therapeutic anticoagulation therapy in the presence of thromboembolism in 7 patients (2%), and complication of anticoagulation therapy in 8 patients (3%). There were no procedure-related deaths or septic complications. Technical complications occurred in 12 patients (4%). Filter misplacement occurred in 6 patients (2%), access thrombosis in 1 (<1%), migration in 1 (<1%), bleeding in 1 (<1%), and IVC occlusion in 3 (1%). Pulmonary emboli after IVC filter placement occurred in one patient with a misplaced filter. Average hospital charges related to duplex ultrasound-directed filter placement were $2388 less than fluoroscopic placement charges in the year 2000.ConclusionOur experience indicates that duplex ultrasound-directed IVC filter placement is safe, cost-effective, and convenient for patients who need IVC filter placement.

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