Journal Article Comparative Study Epublish 2 citations
PubMed: 42436733 DOI: 10.1016/j.rpth.2026.106797
Outcomes in venous thromboembolism with retained vs removed inferior vena cava filters: an analysis from the Registro Informatizado de Enfermedad TromboEmbólica.
Res Pract Thromb Haemost 10(4):106797
Authors: Omri Cohen, Davide Santagata, Gili Kenet, Juan José López-Núñez, My Hanh Bui, Andris Skride, Patricia López-Miguel, Raimundo Tirado, Fernando Arméstar, Manuel Monreal
Affiliations
- Department of Transfusion Medicine, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. Department of Medicine and Surgery, Research Center on Thrombosis and Antithrombotic Therapies, University of Insubria, Varese, Italy.
- Department of Medicine and Surgery, Research Center on Thrombosis and Antithrombotic Therapies, University of Insubria, Varese, Italy.
- National Hemophilia Center & Institute of Thrombosis & Hemostasis, Sheba Medical Center, Ramat Gan, Israel.
- Department of Internal Medicine, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Spain; Institut de Recerca Germans Trias i Pujol, Badalona, Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain.
- Department of Scientific Research Management, Hanoi Medical University and Hanoi Medical University Hospital, Hanoi, Vietnam.
- Department of Cardiology, Ospedale Pauls Stradiņš Clinical University Hospital, Riga Stradiņš University, Riga, Latvia.
- Department of Pneumonology, Hospital General Universitario de Albacete, Albacete, Spain.
- Department of Internal Medicine, Hospital Infanta Margarita, Córdoba, Spain.
- Department of Intensive Care Medicine, Hospital Universitario Germans Trias i Pujol, Badalona, Spain.
- Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM-Universidad Católica San Antonio de Murcia, Spain; CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain.
Abstract
BACKGROUND
Retrievable inferior vena cava (IVC) filters are used in patients with acute venous thromboembolism (VTE) who have temporary contraindications to anticoagulation. Although guidelines recommend removing filters once anticoagulation is feasible, many filters remain in place. Long-term consequences of retention remain unclear.
OBJECTIVES
This study compared clinical outcomes in patients with VTE and retrievable IVC filters, according to filter status and anticoagulation use.
METHODS
We analyzed patients from the international RIETE (Registro Informatizado de Enfermedad TromboEmbólica) registry who received retrievable IVC filters. Outcomes from day 90 onward were stratified by filter status (removed vs retained) and anticoagulation (on vs off). Primary endpoints included VTE recurrence, major bleeding, and all-cause mortality. Filter-related complications were assessed.
RESULTS
Among 1186 patients (mean age, 62 years; 51% male), 51.9% had filters removed by day 90. Patients with retained filters more often had active cancer and received longer anticoagulation, primarily low-molecular-weight heparin. VTE recurrence was higher with retained filters (4.5-6.5 vs 1.2-1.3 events per 100 patient-years), mainly as deep vein thrombosis; removal was associated with lower risk (adjusted incidence rate ratio, 0.29; 95% CI, 0.15-0.54). All-cause mortality was higher in patients with retained filters (7.3-17.7 vs 3.8-4.5; removal: adjusted odds ratio, 0.53; 95% CI, 0.34-0.81). Major bleeding was infrequent, with higher rates in patients with retained filters off anticoagulation. Filter-related complications were rare and did not differ significantly between groups after adjustment.
CONCLUSION
In this large registry, retained IVC filters were associated with higher risk of VTE recurrence, even with extended anticoagulation. Findings support structured follow-up and timely filter retrieval.
MeSH
Registries, Anticoagulants, Mortality, Vena Cava Filters, Thromboembolism, Hemorrhage, Incidence, Vena Cava, Inferior, Venous Thromboembolism