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Thromb Haemost 2005; 93(06): 1117-1119
DOI: 10.1160/TH04-10-0645
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

High utilization rate of vena cava filters in deep vein thrombosis

on behalf of the DVT-FREE Registry
Michael R. Jaff
1   Massachusetts General Hospital, Boston, Massachusetts, USA
,
Samuel Z. Goldhaber
2   Brigham and Women's Hospital, Boston, Massachusetts, USA
,
Victor F. Tapson
3   Duke University Medical Center, Durham, North Carolina, USA
› Author AffiliationsGrant support: This study was funded by an educational grant from Sanofi-Aventis Pharmaceuticals Inc.
Further Information

Publication History

Received 04 October 2004

Accepted after revision 01 March 2005

Publication Date:
11 December 2017 (online)

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Summary

The objective was to investigate newly diagnosed patients with deep vein thrombosis (DVT) who received inferior vena cava filters (IVCFs). A prospective registry enrolled 5451 patients from 183 US study sites. In all patients, examination by venous duplex ultrasound confirmed the diagnosis of DVT. We collected and analyzed data on 781 patients who received an IVCF . The most frequently prescribed treatments were low–molecular-weight heparin and unfractionated heparin, which were used as a bridge to warfarin in 39% (n=2143) and 35% (n=1926) of patients, respectively. Of the total population, 781 (14%) (235 outpatients, 546 inpatients) underwent IVCF placement. The most common reasons for IVCF placement were contraindication to anticoagulation (n = 271), prophylaxis (n = 259), major bleeding related to anticoagulation therapy (n = 92), and anticoagulation failure (n = 73). Multivariate analysis revealed that patients were more likely to undergo IVCF insertion with multiple system organ failure (odds ratio [OR], 3.6; 95% CI, 1.48–8.60), previous stroke (OR, 3.2; 95% CI, 2.11–4.74), or history of pulmonary embolism (OR, 2.4; 95% CI, 1.95–2.91). In conclusion, a surprisingly high 14% (781) of patients with confirmed DVT received an IVCF. Many of these patients may have warranted less invasive methods of venous thromboembolism prophylaxis. Improved physician education regarding mechanical and pharmacologic prophylaxis alternatives might reduce the use of IVCFs.

Keywords

Deep vein thrombosis - pulmonary embolism - heparins / glycosaminoglycans - intravascular devices
 

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