Patterns of referral for inferior vena caval filtration: delays and their impact.

OBJECTIVE

We sought to study the referral patterns for inferior vena caval filtration and explore the relationship between delays in filter insertion and clinical outcomes.

MATERIALS AND

METHODS

We retrospectively reviewed 101 consecutive inferior vena caval filters inserted in 101 patients in a university hospital between the June 2000 and July 2001. A time line was created listing the time of diagnosis of deep venous thrombosis or pulmonary embolism, contraindication or complication of anticoagulation therapy, and time of insertion of inferior vena caval filter.

RESULTS

The average elapsed time between the clinical indication for caval filtration and filter placement in all patients was 1.64 days (range, 0-17 days). Two patients (2%) sustained pulmonary emboli after being diagnosed with deep venous thrombosis before receiving a filter. The lengths of time between filter indication and insertion for these patients were 2 and 8 days.

CONCLUSION

In our hospital, there are wide variations in perceived urgency of vena caval filtration. In two patients, delays longer than 24 hr between indication and insertion of inferior vena caval filters resulted in symptomatic pulmonary emboli.