Practice patterns and outcomes of retrievable vena cava filters in trauma patients: An AAST multicenter study

Riyad Karmy-Jones, Gregory J. Jurkovich, George C. Velmahos, Thomas Burdick, Konstantinos Spaniolas, Samuel R. Todd, Michael McNally, Robert C. Jacoby, Daniel Link, Randy J. Janczyk, Felicia A. Ivascu, Michael McCann, Farouck Obeid, William S. Hoff, Nathaniel McQuay, Brandon H. Tieu, Martin A. Schreiber, Ram Nirula, Karen Brasel, Julie A. DunnDebbie Gambrell, Roger Huckfeldt, Jayna Harper, Kathryn B. Schaffer, Gail T. Tominaga, Fausto Y. Vinces, David Sperling, David Hoyt, Raul Coimbra, Mathew R. Rosengart, Raquel Forsythe, Clay Cothren, Ernest E. Moore, Elliott Haut, Awori J. Hayanga, Linda Hird, Christopher White, Jodi Grossman, Kimberly Nagy, West Livaudais, Rhonda Wood, Imme Zengerink, John B. Kortbeek

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The purpose of this study is to describe practice patterns and outcomes of posttraumatic retrievable inferior vena caval filters (R-IVCF). METHODS: A retrospective review of R-IVCFs placed during 2004 at 21 participating centers with follow up to July 1, 2005 was performed. Primary outcomes included major complications (migration, pulmonary embolism [PE], and symptomatic caval occlusion) and reasons for failure to retrieve. RESULTS: Of 446 patients (69% male, 92% blunt trauma) receiving R-IVCFs, 76% for prophylactic indications and 79% were placed by interventional radiology. Excluding 33 deaths, 152 were Gunter-Tulip (G-T), 224 Recovery (R), and 37 Optease (Opt). Placement occurred 6 ± 8 days after admission and retrieval at 50 ± 61 days. Follow up after discharge (5.7 ± 4.3 months) was reported in 51%. Only 22% of R-IVCFs were retrieved. Of 115 patients in whom retrieval was attempted, retrieval failed as a result of technical issues in 15 patients (10% of G-T, 14% of R, 27% of Opt) and because of significant residual thrombus within the filter in 10 patients (6% of G-T, 4% of R, 46% Opt). The primary reason R-IVCFs were not removed was because of loss to follow up (31%), which was sixfold higher (6% to 44%, p = 0.001) when the service placing the R-IVCF was not directly responsible for follow up. Complications did not correlate with mechanism, injury severity, service placing the R-IVCF, trauma volume, use of anticoagulation, age, or sex. Three cases of migration were recorded (all among R, 1.3%), two breakthrough PE (G-T 0.6% and R 0.4%) and six symptomatic caval occlusions (G-T 0, R 1%, Opt 11%) (p <0.05 Opt versus both G-T and R). CONCLUSION: Most R-IVCFs are not retrieved. The service placing the R-IVCF should be responsible for follow up. The Optease was associated with the greatest incidence of residual thrombus and symptomatic caval occlusion. The practice patterns of R-IVCF placement and retrieval should be re-examined.

Original languageEnglish (US)
Pages (from-to)17-24
Number of pages8
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume62
Issue number1
DOIs
StatePublished - Jan 2007

Fingerprint

Vena Cava Filters
Venae Cavae
Tulipa
Multicenter Studies
Wounds and Injuries
Pulmonary Embolism
Thrombosis
Interventional Radiology
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Karmy-Jones, R., Jurkovich, G. J., Velmahos, G. C., Burdick, T., Spaniolas, K., Todd, S. R., ... Kortbeek, J. B. (2007). Practice patterns and outcomes of retrievable vena cava filters in trauma patients: An AAST multicenter study. Journal of Trauma - Injury, Infection and Critical Care, 62(1), 17-24. https://doi.org/10.1097/TA.0b013e31802dd72a

Practice patterns and outcomes of retrievable vena cava filters in trauma patients : An AAST multicenter study. / Karmy-Jones, Riyad; Jurkovich, Gregory J.; Velmahos, George C.; Burdick, Thomas; Spaniolas, Konstantinos; Todd, Samuel R.; McNally, Michael; Jacoby, Robert C.; Link, Daniel; Janczyk, Randy J.; Ivascu, Felicia A.; McCann, Michael; Obeid, Farouck; Hoff, William S.; McQuay, Nathaniel; Tieu, Brandon H.; Schreiber, Martin A.; Nirula, Ram; Brasel, Karen; Dunn, Julie A.; Gambrell, Debbie; Huckfeldt, Roger; Harper, Jayna; Schaffer, Kathryn B.; Tominaga, Gail T.; Vinces, Fausto Y.; Sperling, David; Hoyt, David; Coimbra, Raul; Rosengart, Mathew R.; Forsythe, Raquel; Cothren, Clay; Moore, Ernest E.; Haut, Elliott; Hayanga, Awori J.; Hird, Linda; White, Christopher; Grossman, Jodi; Nagy, Kimberly; Livaudais, West; Wood, Rhonda; Zengerink, Imme; Kortbeek, John B.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 62, No. 1, 01.2007, p. 17-24.

Research output: Contribution to journalArticle

Karmy-Jones, R, Jurkovich, GJ, Velmahos, GC, Burdick, T, Spaniolas, K, Todd, SR, McNally, M, Jacoby, RC, Link, D, Janczyk, RJ, Ivascu, FA, McCann, M, Obeid, F, Hoff, WS, McQuay, N, Tieu, BH, Schreiber, MA, Nirula, R, Brasel, K, Dunn, JA, Gambrell, D, Huckfeldt, R, Harper, J, Schaffer, KB, Tominaga, GT, Vinces, FY, Sperling, D, Hoyt, D, Coimbra, R, Rosengart, MR, Forsythe, R, Cothren, C, Moore, EE, Haut, E, Hayanga, AJ, Hird, L, White, C, Grossman, J, Nagy, K, Livaudais, W, Wood, R, Zengerink, I & Kortbeek, JB 2007, 'Practice patterns and outcomes of retrievable vena cava filters in trauma patients: An AAST multicenter study', Journal of Trauma - Injury, Infection and Critical Care, vol. 62, no. 1, pp. 17-24. https://doi.org/10.1097/TA.0b013e31802dd72a
Karmy-Jones, Riyad ; Jurkovich, Gregory J. ; Velmahos, George C. ; Burdick, Thomas ; Spaniolas, Konstantinos ; Todd, Samuel R. ; McNally, Michael ; Jacoby, Robert C. ; Link, Daniel ; Janczyk, Randy J. ; Ivascu, Felicia A. ; McCann, Michael ; Obeid, Farouck ; Hoff, William S. ; McQuay, Nathaniel ; Tieu, Brandon H. ; Schreiber, Martin A. ; Nirula, Ram ; Brasel, Karen ; Dunn, Julie A. ; Gambrell, Debbie ; Huckfeldt, Roger ; Harper, Jayna ; Schaffer, Kathryn B. ; Tominaga, Gail T. ; Vinces, Fausto Y. ; Sperling, David ; Hoyt, David ; Coimbra, Raul ; Rosengart, Mathew R. ; Forsythe, Raquel ; Cothren, Clay ; Moore, Ernest E. ; Haut, Elliott ; Hayanga, Awori J. ; Hird, Linda ; White, Christopher ; Grossman, Jodi ; Nagy, Kimberly ; Livaudais, West ; Wood, Rhonda ; Zengerink, Imme ; Kortbeek, John B. / Practice patterns and outcomes of retrievable vena cava filters in trauma patients : An AAST multicenter study. In: Journal of Trauma - Injury, Infection and Critical Care. 2007 ; Vol. 62, No. 1. pp. 17-24.
@article{8ee9b5b19d3b469c925b3b9db9ed9f20,
title = "Practice patterns and outcomes of retrievable vena cava filters in trauma patients: An AAST multicenter study",
abstract = "BACKGROUND: The purpose of this study is to describe practice patterns and outcomes of posttraumatic retrievable inferior vena caval filters (R-IVCF). METHODS: A retrospective review of R-IVCFs placed during 2004 at 21 participating centers with follow up to July 1, 2005 was performed. Primary outcomes included major complications (migration, pulmonary embolism [PE], and symptomatic caval occlusion) and reasons for failure to retrieve. RESULTS: Of 446 patients (69{\%} male, 92{\%} blunt trauma) receiving R-IVCFs, 76{\%} for prophylactic indications and 79{\%} were placed by interventional radiology. Excluding 33 deaths, 152 were Gunter-Tulip (G-T), 224 Recovery (R), and 37 Optease (Opt). Placement occurred 6 ± 8 days after admission and retrieval at 50 ± 61 days. Follow up after discharge (5.7 ± 4.3 months) was reported in 51{\%}. Only 22{\%} of R-IVCFs were retrieved. Of 115 patients in whom retrieval was attempted, retrieval failed as a result of technical issues in 15 patients (10{\%} of G-T, 14{\%} of R, 27{\%} of Opt) and because of significant residual thrombus within the filter in 10 patients (6{\%} of G-T, 4{\%} of R, 46{\%} Opt). The primary reason R-IVCFs were not removed was because of loss to follow up (31{\%}), which was sixfold higher (6{\%} to 44{\%}, p = 0.001) when the service placing the R-IVCF was not directly responsible for follow up. Complications did not correlate with mechanism, injury severity, service placing the R-IVCF, trauma volume, use of anticoagulation, age, or sex. Three cases of migration were recorded (all among R, 1.3{\%}), two breakthrough PE (G-T 0.6{\%} and R 0.4{\%}) and six symptomatic caval occlusions (G-T 0, R 1{\%}, Opt 11{\%}) (p <0.05 Opt versus both G-T and R). CONCLUSION: Most R-IVCFs are not retrieved. The service placing the R-IVCF should be responsible for follow up. The Optease was associated with the greatest incidence of residual thrombus and symptomatic caval occlusion. The practice patterns of R-IVCF placement and retrieval should be re-examined.",
author = "Riyad Karmy-Jones and Jurkovich, {Gregory J.} and Velmahos, {George C.} and Thomas Burdick and Konstantinos Spaniolas and Todd, {Samuel R.} and Michael McNally and Jacoby, {Robert C.} and Daniel Link and Janczyk, {Randy J.} and Ivascu, {Felicia A.} and Michael McCann and Farouck Obeid and Hoff, {William S.} and Nathaniel McQuay and Tieu, {Brandon H.} and Schreiber, {Martin A.} and Ram Nirula and Karen Brasel and Dunn, {Julie A.} and Debbie Gambrell and Roger Huckfeldt and Jayna Harper and Schaffer, {Kathryn B.} and Tominaga, {Gail T.} and Vinces, {Fausto Y.} and David Sperling and David Hoyt and Raul Coimbra and Rosengart, {Mathew R.} and Raquel Forsythe and Clay Cothren and Moore, {Ernest E.} and Elliott Haut and Hayanga, {Awori J.} and Linda Hird and Christopher White and Jodi Grossman and Kimberly Nagy and West Livaudais and Rhonda Wood and Imme Zengerink and Kortbeek, {John B.}",
year = "2007",
month = "1",
doi = "10.1097/TA.0b013e31802dd72a",
language = "English (US)",
volume = "62",
pages = "17--24",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Practice patterns and outcomes of retrievable vena cava filters in trauma patients

T2 - An AAST multicenter study

AU - Karmy-Jones, Riyad

AU - Jurkovich, Gregory J.

AU - Velmahos, George C.

AU - Burdick, Thomas

AU - Spaniolas, Konstantinos

AU - Todd, Samuel R.

AU - McNally, Michael

AU - Jacoby, Robert C.

AU - Link, Daniel

AU - Janczyk, Randy J.

AU - Ivascu, Felicia A.

AU - McCann, Michael

AU - Obeid, Farouck

AU - Hoff, William S.

AU - McQuay, Nathaniel

AU - Tieu, Brandon H.

AU - Schreiber, Martin A.

AU - Nirula, Ram

AU - Brasel, Karen

AU - Dunn, Julie A.

AU - Gambrell, Debbie

AU - Huckfeldt, Roger

AU - Harper, Jayna

AU - Schaffer, Kathryn B.

AU - Tominaga, Gail T.

AU - Vinces, Fausto Y.

AU - Sperling, David

AU - Hoyt, David

AU - Coimbra, Raul

AU - Rosengart, Mathew R.

AU - Forsythe, Raquel

AU - Cothren, Clay

AU - Moore, Ernest E.

AU - Haut, Elliott

AU - Hayanga, Awori J.

AU - Hird, Linda

AU - White, Christopher

AU - Grossman, Jodi

AU - Nagy, Kimberly

AU - Livaudais, West

AU - Wood, Rhonda

AU - Zengerink, Imme

AU - Kortbeek, John B.

PY - 2007/1

Y1 - 2007/1

N2 - BACKGROUND: The purpose of this study is to describe practice patterns and outcomes of posttraumatic retrievable inferior vena caval filters (R-IVCF). METHODS: A retrospective review of R-IVCFs placed during 2004 at 21 participating centers with follow up to July 1, 2005 was performed. Primary outcomes included major complications (migration, pulmonary embolism [PE], and symptomatic caval occlusion) and reasons for failure to retrieve. RESULTS: Of 446 patients (69% male, 92% blunt trauma) receiving R-IVCFs, 76% for prophylactic indications and 79% were placed by interventional radiology. Excluding 33 deaths, 152 were Gunter-Tulip (G-T), 224 Recovery (R), and 37 Optease (Opt). Placement occurred 6 ± 8 days after admission and retrieval at 50 ± 61 days. Follow up after discharge (5.7 ± 4.3 months) was reported in 51%. Only 22% of R-IVCFs were retrieved. Of 115 patients in whom retrieval was attempted, retrieval failed as a result of technical issues in 15 patients (10% of G-T, 14% of R, 27% of Opt) and because of significant residual thrombus within the filter in 10 patients (6% of G-T, 4% of R, 46% Opt). The primary reason R-IVCFs were not removed was because of loss to follow up (31%), which was sixfold higher (6% to 44%, p = 0.001) when the service placing the R-IVCF was not directly responsible for follow up. Complications did not correlate with mechanism, injury severity, service placing the R-IVCF, trauma volume, use of anticoagulation, age, or sex. Three cases of migration were recorded (all among R, 1.3%), two breakthrough PE (G-T 0.6% and R 0.4%) and six symptomatic caval occlusions (G-T 0, R 1%, Opt 11%) (p <0.05 Opt versus both G-T and R). CONCLUSION: Most R-IVCFs are not retrieved. The service placing the R-IVCF should be responsible for follow up. The Optease was associated with the greatest incidence of residual thrombus and symptomatic caval occlusion. The practice patterns of R-IVCF placement and retrieval should be re-examined.

AB - BACKGROUND: The purpose of this study is to describe practice patterns and outcomes of posttraumatic retrievable inferior vena caval filters (R-IVCF). METHODS: A retrospective review of R-IVCFs placed during 2004 at 21 participating centers with follow up to July 1, 2005 was performed. Primary outcomes included major complications (migration, pulmonary embolism [PE], and symptomatic caval occlusion) and reasons for failure to retrieve. RESULTS: Of 446 patients (69% male, 92% blunt trauma) receiving R-IVCFs, 76% for prophylactic indications and 79% were placed by interventional radiology. Excluding 33 deaths, 152 were Gunter-Tulip (G-T), 224 Recovery (R), and 37 Optease (Opt). Placement occurred 6 ± 8 days after admission and retrieval at 50 ± 61 days. Follow up after discharge (5.7 ± 4.3 months) was reported in 51%. Only 22% of R-IVCFs were retrieved. Of 115 patients in whom retrieval was attempted, retrieval failed as a result of technical issues in 15 patients (10% of G-T, 14% of R, 27% of Opt) and because of significant residual thrombus within the filter in 10 patients (6% of G-T, 4% of R, 46% Opt). The primary reason R-IVCFs were not removed was because of loss to follow up (31%), which was sixfold higher (6% to 44%, p = 0.001) when the service placing the R-IVCF was not directly responsible for follow up. Complications did not correlate with mechanism, injury severity, service placing the R-IVCF, trauma volume, use of anticoagulation, age, or sex. Three cases of migration were recorded (all among R, 1.3%), two breakthrough PE (G-T 0.6% and R 0.4%) and six symptomatic caval occlusions (G-T 0, R 1%, Opt 11%) (p <0.05 Opt versus both G-T and R). CONCLUSION: Most R-IVCFs are not retrieved. The service placing the R-IVCF should be responsible for follow up. The Optease was associated with the greatest incidence of residual thrombus and symptomatic caval occlusion. The practice patterns of R-IVCF placement and retrieval should be re-examined.

UR - http://www.scopus.com/inward/record.url?scp=33846226087&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33846226087&partnerID=8YFLogxK

U2 - 10.1097/TA.0b013e31802dd72a

DO - 10.1097/TA.0b013e31802dd72a

M3 - Article

C2 - 17215729

AN - SCOPUS:33846226087

VL - 62

SP - 17

EP - 24

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 1

ER -