Pulmonary vascular disease & thromboembolism
Postmarketing Surveillance of Inferior Vena Cava Filters Among US Medicare Beneficiaries: The SAFE-IVC Study
Authors' conclusion
In this large, US real-world analysis, IVCF insertion declined, yet retrievals remained low.
Study context
- Population
- US Medicare Fee-for-Service (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)
Methodological detailsprespecified, observational, Medicare FFS claims, 100% sample
- Prespecified
- Observational
- Medicare FFS claims, 100% sample
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: The SAFE-IVC Study. JAMA. Published 24 December 2024. doi:10.
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