TY - JOUR
T1 - Comparative outcomes of Inferior Vena Cava filters placed at bedside using digital radiography versus conventional fluoroscopy
AU - Walker, John A.
AU - Milam, Matthew
AU - Lopera, Jorge E.
N1 - Publisher Copyright:
© 2021 Shanghai Journal of Interventional Radiology Press
PY - 2021/8
Y1 - 2021/8
N2 - Purpose: To retrospectively assess the outcomes of Inferior Vena Cava (IVC) filters placed in critically ill patients in the ICU at bedside using digital radiograph (DR) guidance with previous cross-sectional imaging for planning, compared to IVC filters placed by conventional fluoroscopy (CF). Method and materials: The cohort consisted of 129 IVC filter placements; 48 placed at bedside and 81 placed conventionally from July 2015 to September 2016. Patient demographics, indication, radiation exposures, access site, procedural duration, dwell time, and complications were identified by the EMR. IVC Filter positioning with measurements of tip to renal vein distance and lateral filter tilt were performed when cavograms or post placement CTs were available for review. Statistical analysis was performed using Stata IC 11.2. Results: Technical success of the procedure was 100% in both groups. Procedural duration was longer at the bedside lasting 14.5 +/- 10.2 versus 6.7 +/- 6.0 min (p<0.0001). The bedside DR group had a median radiation exposure of 25 mGy (15–35) and the CF group had mean radiation exposure of 256.94 mGy +/- 158.6. There was no significant difference in distance of IVC tip to renal vein (p=0.31), mispositioning (p=0.59), degree of filter tilt (p=0.33), or rate of complications (p=0.65) between the two groups. Conclusion: IVCF placement at the bedside using DR is comparable to CF with no statistical difference in outcomes based on IVCF positioning, degree of lateral tilt or removal issues. It decreased radiation dose, but with overall increased procedural time.
AB - Purpose: To retrospectively assess the outcomes of Inferior Vena Cava (IVC) filters placed in critically ill patients in the ICU at bedside using digital radiograph (DR) guidance with previous cross-sectional imaging for planning, compared to IVC filters placed by conventional fluoroscopy (CF). Method and materials: The cohort consisted of 129 IVC filter placements; 48 placed at bedside and 81 placed conventionally from July 2015 to September 2016. Patient demographics, indication, radiation exposures, access site, procedural duration, dwell time, and complications were identified by the EMR. IVC Filter positioning with measurements of tip to renal vein distance and lateral filter tilt were performed when cavograms or post placement CTs were available for review. Statistical analysis was performed using Stata IC 11.2. Results: Technical success of the procedure was 100% in both groups. Procedural duration was longer at the bedside lasting 14.5 +/- 10.2 versus 6.7 +/- 6.0 min (p<0.0001). The bedside DR group had a median radiation exposure of 25 mGy (15–35) and the CF group had mean radiation exposure of 256.94 mGy +/- 158.6. There was no significant difference in distance of IVC tip to renal vein (p=0.31), mispositioning (p=0.59), degree of filter tilt (p=0.33), or rate of complications (p=0.65) between the two groups. Conclusion: IVCF placement at the bedside using DR is comparable to CF with no statistical difference in outcomes based on IVCF positioning, degree of lateral tilt or removal issues. It decreased radiation dose, but with overall increased procedural time.
KW - Deep venous thrombosis
KW - Inferior vena cava filters
KW - Pulmonary embolism
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U2 - 10.1016/j.jimed.2021.05.001
DO - 10.1016/j.jimed.2021.05.001
M3 - Article
C2 - 34805962
AN - SCOPUS:85115867372
SN - 2096-3602
VL - 4
SP - 139
EP - 142
JO - Journal of Interventional Medicine
JF - Journal of Interventional Medicine
IS - 3
ER -