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Taking the inferior out of inferior vena cava filter follow-up


To the Editor: Follow-up of inferior vena cava (IVC) filters after insertion is a task that is variably successful. This was highlighted by a recent article describing poor removal rates of IVC filters at our institution between 2007 and 2009.1 Since that time, the interventional radiology (IR) department has established a filter database and clinic with the aim of improving IVC filter monitoring and removal. This radiology-driven initiative has been integrated into the standard interventional procedures and has proven extremely effective. Based on the success of this program, we advocate strongly that IVC filter follow-up should be the responsibility of those who provide the insertion service.

Between 2011 and 2013, all 87 IVC filters inserted by IR at St Vincent’s Hospital Melbourne have been accounted for; 44 have been removed, 33 were planned not for removal (eg, patients with a poor prognosis or contraindications), and 10 are awaiting removal or review in our IR clinic. The average indwelling time for IVC filters inserted between 2011 and 2013 was 23 weeks (range, 1–130 weeks), with 71/87 filters remaining in situ for less than 6 months. The average time in situ fell from 35 weeks in 2011 to 14 weeks in 2013. These…