Inferior Vena Cava Filters: Analysis of a Database
Condition: Deep Vein Thrombosis, Pulmonary Embolus
MeSH terms: Pulmonary Embolism; Thrombosis; Venous Thrombosis
Study type: Observational

Summary: 
      In this study a retrospective analysis of patients database was performed, who underwent
      treatment for deep vein thrombosis in tertiary hospital by using inferior vena cava-filters
    

Detailed description: 
      The aim of this research was to assess the cava-filter implantation frequency in a tertiary
      hospital with venous thromboembolism treatment center.

      A retrospective analysis of patient's database was performed, who underwent treatment in the
      tertiary clinic between 2016 - 2017. In total, 2399 patients with venous thromboembolism were
      hospitalized, 442 cava-filters were implanted (239 in 2016 and 203 in 2017), which accounted
      for 18.4% of patients with venous thromboembolism. Removable cava-filters models were used in
      most cases (98.8%). Contraindications for anticoagulation were reason for cava-filters
      implantation in 119 (26.9%) cases, and in 184 patients (41.6%) cava-filters were implanted
      due to the inefficiency of anticoagulation. 38 (8.6%) patients with deep vein thrombosis
      (DVT) and pulmonary embolism had pulmonary hypertension of the 2nd to 3rd degree, which
      caused the implantation of cava-filters .

      The occlusion of the inferior vena cava and cava-filters verified in 116 (26.9%) patients
      after cava-filters implantation, based on repeated ultrasound. The overall mortality rate in
      the group of patients with venous thromboembolism was 0.25% (6 patients), 5 of them (1.1%)
      underwent cava-filters implantation. The cause of all lethal outcomes was the progression of
      the underlying disease. During the next hospitalization 29 (6.5%) of implanted filters were
      endovascularly removed.

      There are 18.4% of patients with venous thromboembolism undergoing cava-filters implantation
      for various reasons in a tertiary hospital. At the same time, occlusion of the inferior vena
      cava and cava-filters in the early post implantation period is observed in 26.9%. However,
      without clear criteria for the differentiation of cava-filters embolism from its thrombosis,
      we cannot assess whether this was a complication, or if the cava-filters completed its task
      by preventing pulmonary embolism. Thus, the validity of implanting cava filters question in
      terms of efficiency and safety remains unanswered, which poses the task for deep study of
      this problem and thorough analysis of the indications for the cava-filters implantation.
    

Observational model: Cohort
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        2399 patients who were either hospitalized with venous thromboembolism or diagnosed with
        venous thromboembolism during hospital stay in 2016-2017. Of them there were 1173 male
        (48,9%) and 1226 female (51,1%) patients with average age of 62,4 ± 15,2 (min - 16, max -
        96).
      
Keywords: deep vein thrombosis; inferior vena cava-filter; pulmonary embolism