Pulmonary vascular disease & thromboembolismCohort study
Postmarketing Surveillance of Inferior Vena Cava Filters Among US Medicare Beneficiaries
- Retrospective cohort study
- prespecified
- observational
- Medicare Fee-for-Service (FFS) claims, 100% sample
Authors' conclusion
In this large, US real-world analysis, IVCF insertion declined, yet retrievals remained low.
Study context
- Population
- US Medicare FFS beneficiaries with first-time IVC filter insertion, 2013–2021
- Participants
- 270,866 beneficiaries
- Outcome
- Composite of:
- All-cause death
- Filter-related complications
- Operating room visits after filter-related procedures
- New DVT (periprocedural ≤30 days; long-term >30 days)
Main finding
As reported in the abstract
IVCF insertions per year, 2013
44 680
IVCF insertions per year, 2021
19 501
Cumulative incidence of retrieval at median 1.2 years
15.3%
Cumulative incidence of retrieval at maximum follow-up of 9.0 years
16.8%
Observational data: associations, not effects.
Further findings
Indication for insertion
- First-time venous thromboembolism (VTE)
- 64.9%
- Recurrent VTE
- 26.3%
- VTE prophylaxis
- 8.8%
- Major bleeds or trauma within 30 days of insertion
- 63.3%
Predictors of retrieval
- Older age, more comorbidities and Black race associated with decreased likelihood of retrieval; placement at a large teaching hospital with increased likelihood
Retrieval success
- Successful retrieval attempts
- 93.5%
Safety
Caval thrombosis and DVT, nonretrieved inferior vena cava filters (IVCFs)
- Caval thrombosis
- 2.2% (95% CI, 2.1%-2.3%)
- DVT
- 9.2% (95% CI, 9.0%-9.3%)
30-day complications after retrieval
- Mortality
- 0.7% [95% CI, 0.6%-0.8%]
- Filter-related complications
- 1.4% [95% CI, 1.2%-1.5%]
Original publication
Postmarketing Surveillance of Inferior Vena Cava Filters Among US Medicare Beneficiaries. JAMA. Published 24 December 2024. doi:10.1001/jama.2024.19553
Summarised from the published abstract; every number is checked against it