A semiautomated process for tracking patients with inferior vena cava (IVC) filters can improve patient care, according to a new study published in the American Journal of Roentgenology.
“Although most modern IVC filters are retrievable, these devices are infrequently removed when the risk of pulmonary embolism subsides,” wrote author Krishna Juluru, MD, from the department of radiology at Memorial Sloan Kettering Cancer Center in New York, and colleagues. “Long indwelling times in turn can increase the risk of complications or can limit the ability to remove filters.”
The authors noted that this increased risk of complications is severe enough that the FDA has said retrievable IVC filters should be removed as soon as possible. And implementing an IVC filter-tracking system, which the team did at its own facility, is one method that can ensure the filters are retrieved in a timely manner.
“By designing a platform to facilitate physician communication before scheduling clinic visits, we intended to identify which patients could benefit from face-to-face discussion regarding a filter retrieval procedure or an ongoing need for filtration,” Juluru et al. wrote. “Patients with changes in clinical status warranting permanent venous filtration or patients whose risks of filter retrieval outweighed the risk of attempting removal were not required to schedule a clinic visit with interventional radiology (IR) unless requested.”
The authors implemented a semiautomated filter-tracking application that queried their facility’s RIS and built a database of patients with a retrievable IVC. Key information was displayed, specialists were able to communicate with referring physicians and management was decided based on each patient’s condition. Developing the system took approximately 100 hours.
A total of 293 IVC filter placements and 83 filter retrievals were tracked from July 2016 to December 2016. July 2015 to December 2015 was used as a control period.
Overall, the filter retrieval rate was 34 percent during the test period, up from 23 percent during the control period. There was not a significant difference in the mean time between filter placement and retrieval.
“During the test period, the application reliably and consistently tracked all IVC filter placements within our institution, facilitated communication between the IR service and referring physicians, and was associated with a trend toward increased filter retrieval rates over a short-term evaluation period,” the authors concluded.