HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text (PDF) Free All Versions of this Article: chest.06-2897v1 132/1/31    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hoppe, H. Articles by Keller, F. S. Search for Related Content PubMed PubMed Citation Articles by Hoppe, H. Articles by Keller, F. S.

Safety of inferior vena cava filter retrieval in anticoagulated patients

¹Dotter Interventional Institute, Oregon Health & Science University, Portland, OR ²Department of Angiography, Portland Veterans Administration Medical Center, Portland, OR ³Division of Hematology and Medical Oncology, Oregon Health and Sciences University, Portland, OR

hoppeh{at}ohsu.edu

Abstract

PurposeTo evaluate the safety of inferior vena cava (IVC) filter retrieval in therapeutically anticoagulated patients in comparison to prophylactically or not therapeutically anticoagulated patients with respect to retrieval-related hemorrhagic complications.

Materials and MethodsThis was a retrospective study of 115 consecutive attempted IVC filter retrievals in 110 patients. Filter retrievals were stratified as performed in patients that were therapeutically anticoagulated (group 1), prophylactically anticoagulated (group 2), or not therapeutically anticoagulated (group 3). The collected data included anticoagulant and antiplatelet medications (type, form and duration of administration, dosage) at the time of retrieval. Phone interviews and chart review was performed for the international normalized ratio (INR), activated partial thromboplastin time (aPTT), platelet count, infusion of blood products and retrieval-related hemorrhagic complications.

ResultsGroup 1 included 65 attempted filter retrievals in 61 therapeutically anticoagulated patients by measured INR or dosing when receiving LMWH. Four retrievals were not successful. In patients on oral anticoagulation the median INR was 2.35 (range 2-8). Group 2 comprised 23 successful filter retrievals in 22 patients on a prophylactic dose of LMWH. Group 3 included 27 attempted filter retrievals in 27 not therapeutically anticoagulated patients. Six retrievals were not successful. Five patients were on oral anticoagulation with a subtherapeutic INR (median 1.49, range 1.16-1.69). No anticoagulation medication was administered in 22 patients. In none of the groups hemorrhagic complications related to the retrieval procedures were identified.

ConclusionsThese results suggest that retrieval of vena cava filters in anticoagulated patients is safe. Interruption or reversal of anticoagulation for the retrieval of vena cava filters is not indicated.

Key Words: Vena Cava Filters [E07.695.900] • Pulmonary Embolism [C08.381.746] • Venous Thrombosis [C14.907.355.830.925]