RETRIEVABLE INFERIOR VENA CAVA FILTERS (RIVCF)

The vast majority of IVCF devices placed in the combat theater are Retrievable Inferior Vena Cava Filters (RIVCF). RIVCF are preferred to avoid some of the long-term complications of filter placement. Additionally, many patients only need this form of VTE prophylaxis for a defined period of time early after injury.

Combat injured patients from Operation Iraqi Freedom and Operation Enduring Freedom who had RIVCFs placed have an overall retrieval rate of 18%.54 Despite successful removal of IVCF beyond 180 days and high success and low complication rate for attempted IVCF removal, rates of eventual removal of RIVCFs in multiple studies of trauma patients in the U.S. have been as low as 14% to 22%.36-39,53

It should be noted that the majority of patients was lost to follow up or did not have filters removed due to ongoing indications for use (82%). Therefore, the overall retrieval technical success rate may be much higher. Most series support removal of the most commonly used RIVCFs as early as they are no longer necessary and no later than approximately three months.42 While it is possible to remove any of these later than this time period, the technical success declines significantly as potential complications associated with removal increase. Clear electronic documentation and a dedicated tracking system at the final continental U.S. (CONUS) medical treatment facility (MTF) must be in place to improve retrieval rates and minimize loss to follow up.43