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Abstract

Objective:

To evaluate the anticoagulation therapy of subsegmental nonocclusive filter-related thrombus and identify the risk factors affecting the change in thrombus volume.

Methods:

A single-center retrospective study was performed to review patients who received inferior vena cava filter (IVCF) placements and retrievals from July 2018 to December 2023. Patients with subsegmental nonocclusive filter-related thrombus were included in this study, and clinical data, such as demographics, baseline medical history, types of IVCFs, locations of IVCFs, endovascular management, duration of anticoagulation, and outcomes were collected.

Results:

Based on IVCF location, 32 patients, including 17 men and 15 women (age: 60.94±13.47) were enrolled into infrarenal IVCF group (infra-group), 38 patients, including 28 men and 10 women (age 54.97±12.48) were enrolled into suprarenal IVCF group (supra-group). Demographics, baseline medical history, lower extremity deep vein thrombosis (DVT) characteristics, initial IVCF placement indications, IVCF types, endovascular therapy choice, and the reasons of additional anticoagulation were found no significant difference between the 2 groups (p>0.05). Additional anticoagulation time before IVCF removal in supra-group was significantly longer than infra-group (74.47±42.85 vs 51.25±25.99 p<0.05). After additional anticoagulation, most filter-related thrombus was resolved completely (34/38 vs 20/32) or partially (4/38 vs 9/32), and only 3 patients in infra-group suffered progressed filter-related thrombus. Supra-group had a significantly better outcome of filter-related thrombus than the infra-group (p<0.05).

Conclusion:

Anticoagulation therapy could reduce subsegmental nonocclusive filter-related thrombus burden. Longer anticoagulation period and suprarenal IVCF placement may be the factors influencing the thrombus resolve.

Clinical Impact

The present study found out anticoagulation therapy could reduce subsegmental nonocclusive filter-related thrombus burden, which may provide a better option for filter-related thrombus and improve the retrieval rate of inferior vena cava filters.

Keywords

inferior vena cava filter thrombus anticoagulation retrieval

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References

Kakkos

Gohel

Baekgaard

, et al. Editor’s Choice—European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis. Eur J Vasc Endovasc Surg. 2021;61(1):9–82.

Kesselman

Johnson

, et al. Current controversies in inferior vena cava filter placement: AJR Expert Panel Narrative Review. AJR Am J Roentgenol. 2021;216(3):563–569.

Stevens

Woller

Kreuziger

, et al. Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest. 2021;160(6):e545–e608.

Haddadin

McLennan

, et al. Inferior vena cava filter—comprehensive overview of current indications, techniques, complications and retrieval rates. VASA. 2020;49(6):449–462.

Di Nisio

van Es

Buller

. Deep vein thrombosis and pulmonary embolism. Lancet. 2016;388(10063):3060–3073.

Wassef

Lim

Indications, complications and outcomes of inferior vena cava filters: a retrospective study. Thromb Res. 2017;153:123–128.

Sarosiek

Crowther

Sloan

. Indications, complications, and management of inferior vena cava filters: the experience in 952 patients at an academic hospital with a level I trauma center. JAMA Intern Med. 2013;173(7):513–517.

Ayad

Gillespie

DL.

Long-term complications of inferior vena cava filters. J Vasc Surg Venous Lymphat Disord. 2019;7(1):139–144.

Koizumi

Hara

Sekiguchi

, et al. Multicenter investigation of the incidence of inferior vena cava filter fracture. Jpn J Radiol. 2018;36(11):661–668.

10.

Wang

Siddiqui

Rosenthal

Long-term complications of inferior vena cava filters. J Vasc Surg Venous Lymphat Disord. 2017;5(1):33–41.

11.

Liu

Jiang

Tian

, et al. Clinical outcomes of retrievable inferior vena cava filters for venous thromboembolic diseases. J Comp Eff Res. 2022;11(6):437–449.

12.

Simon

Walker

Daab

, et al. A quality improvement project to improve inferior vena cava filter retrieval. J Vasc Surg Venous Lymphat Disord. 2017;5(1):42–46.

13.

Minocha

Idakoji

Riaz

, et al. Improving inferior vena cava filter retrieval rates: impact of a dedicated inferior vena cava filter clinic. J Vasc Interv Radiol. 2010;21(12):1847–1851.

14.

Cao

Liu

, et al. A better inferior vena cava filter retrieval rate: a retrospective study in a single-center institution. Phlebology. 2020;35(6):424–429.

15.

Cao

Luo

, et al. Removing infrarenal inferior vena cava filters (IVCFs) with thrombus under protection of suprarenal IVCFs: a retrospective study in a single-center institution. Medicine. 2023;102(42):e35574.

16.

Lin

Zeng

, et al. Application of the double series filter technique for the treatment of acute inferior vena cava filter-mediated thrombosis. Ann Vasc Surg. 2024;99:89–95.

17.

Mahrer

Zippel

Garniek

, et al. Retrievable vena cava filters in major trauma patients: prevalence of thrombus within the filter. Cardiovasc Intervent Radiol. 2008;31(4):785–789.

18.

Habito

Kalva

SP.

Inferior vena cava filter thrombosis: a review of current concepts, evidence, and approach to management. Hosp Pract. 2011;39(3):79–86.

19.

Pan

Zhao

Mei

, et al. Retrievable inferior vena cava filters in trauma patients: prevalence and management of thrombus within the filter. Eur J Vasc Endovasc Surg. 2016;52(6):830–837.

20.

Wang

Timmermans

Kaufman

JA.

Estimation of trapped thrombus volumes in retrievable inferior vena cava filters: a visual scale. J Vasc Interv Radiol. 2007;18(2):273–276.

21.

Teo

Angle

Shipp

, et al. Incidence and management of inferior vena cava filter thrombus detected at time of filter retrieval. J Vasc Interv Radiol. 2011;22(11):1514–1520.

22.

Annweiler

Bertoletti

Grange

, et al. Pathological Analysis and Clinical Evolution After Radiological Removal of Retrievable Vena Cava Filters. Vasc Endovascular Surg. 2022;56(8):754–761.

23.

Dehbi

Grange

Poenou

, et al. Temporary inferior vena cava filters factors associated with non-removal. Eur Radiol. 2023;33(4):2585–2592.

24.

Kolbeck

Itkin

Cheatham

, et al. Optional inferior vena cava filter retrieval with retained thrombus: an in vitro model. J Vasc Interv Radiol. 2006;17(4):685–691.

25.

Jiang

Jia

, et al. Incidence and outcomes of inferior vena cava filter thrombus during catheter-directed thrombolysis for proximal deep venous thrombosis. Ann Vasc Surg. 2017;38:305–309.

26.

Saha

Poterucha

Parikh

, et al. The use of AngioVac thrombectomy in IVC filter-associated IVC thrombosis. JACC Cardiovas Interv. 2019;12(5):e41–e3.

27.

Voit

Commander

, et al. Mechanical thrombectomy of inferior vena cava filter-associated caval thrombosis using FlowTriever and ClotTriever systems. J Vasc Surg Venous Lymphat Disord. 2023;11(6):1175–1181.

28.

Liu

Gong

, et al. AngioJet rheolytic thrombectomy to treat inferior vena cava filter-related thrombosis: efficacy and safety compared with large-lumen catheter suction. Front Cardiovasc Med. 2022;9:837455.

29.

Gong

Zhao

Jiang

, et al. AngioJet rheolytic thrombectomy coupled with dose-reduced rt-PA for massive inferior vena cava filter-related thrombosis: a single-center retrospective study. Asian J Surg. 2024;47(1):263–268.

30.

Liu

Tian

, et al. Clinical outcomes of AngioJet pharmacomechanical thrombectomy versus catheter-directed thrombolysis for the treatment of filter-related caval thrombosis. World J Clin Cases. 2023;11(3):598–609.

31.

Baheti

Sheeran

Patrie

, et al. Suprarenal inferior vena cava filter placement and retrieval: safety analysis. J Vasc Interv Radiol. 2020;31(2):231–235.

32.

Gong

Liu

Kong

, et al. Incidence and risk factors for inferior vena cava filter thrombosis detected at time of filter retrieval in patients with lower extremity deep vein thrombosis: a multicenter retrospective cohort study. Quant Imaging Med Surg. 2023;13(12):8313–8325.

33.

Ahmad

Yeddula

Wicky

, et al. Clinical sequelae of thrombus in an inferior vena cava filter. Cardiovasc Intervent Radiol. 2010;33(2):285–289.

34.

Porter

Moneta

GL.

Reporting standards in venous disease: an update. International Consensus Committee on Chronic Venous Disease. J Vasc Surg. 1995;21(4):635–645.

35.

Vedantham

Sista

Klein

, et al. Quality improvement guidelines for the treatment of lower-extremity deep vein thrombosis with use of endovascular thrombus removal. J Vasc Interv Radiol. 2014;25(9):1317–1325.

36.

Alshaqaq

Al-Sharydah

Alshahrani

, et al. Prophylactic inferior vena cava filters for venous thromboembolism in adults with trauma: an updated systematic review and meta-analysis. J Intensive Care Med. 2023;38(6):491–510.

37.

Ryce

Lee

Ahmed

, et al. Contemporary use of prophylactic inferior vena cava filters in patients with severe traumatic injuries and high thromboembolic event risk. J Am Coll Radiol. 2024;21(5):712–720.

38.

Zhao

Zhang

Tsauo

, et al. Comparison of the in vitro clot-capturing efficiencies of commercially available retrievable inferior vena cava filters. J Vasc Surg Venous Lymphat Disord. 2022;10(2):463–468.

39.

Hammer

Rousseau

Joffre

, et al. In vitro evaluation of vena cava filters. J Vasc Interv Radiol. 1994;5(6):869–876.

40.

Buecker

Neuerburg

Schmitz-Rode

, et al. In vitro evaluation of a rheolytic thrombectomy system for clot removal from five different temporary vena cava filters. Cardiovasc Intervent Radiol. 1997;20(6):448–451.

41.

Jaeger

Kolb

Mair

, et al. In vitro model for the evaluation of inferior vena cava filters: effect of experimental parameters on thrombus-capturing efficacy of the Vena Tech-LGM filter. J Vasc Interv Radiol. 1998;9(2):295–304.

42.

Kalva

Chlapoutaki

Wicky

, et al. Suprarenal inferior vena cava filters: a 20-year single-center experience. J Vasc Interv Radiol. 2008;19(7):1041–1047.

Anticoagulation Therapy May Reduce Subsegmental Nonocclusive Inferior Vena Cava Filter–Related Thrombus Burden: A Retrospective Study in a Single-Center Institution

Abstract

Objective:

Methods:

Results:

Conclusion:

Clinical Impact

Keywords

Get full access to this article

References