ABSTRACT
Background
There is a paucity of data comparing the long-term outcomes after inferior vena cava
(IVC) filters placement for patients with acute venous thromboembolism (VTE) between
those with and without active cancer.
Methods
In the COMMAND VTE Registry, we evaluated the effects of IVC filter use on the long-term
clinical outcomes stratified by the presence and absence of active cancer.
Results
Among 2,626 patients with acute symptomatic VTE, there were 604 patients with active
cancer, and 2022 patients without active cancer. IVC filters were placed and not retrieved
in 455 patients (17%) in the entire cohort, in 150 patients (24.8%) in the active
cancer stratum, and in 305 patients (15.1%) in the non-cancer stratum. In the entire
cohort, non-retrieved IVC filter placement was not associated with a lower adjusted
risk for PE recurrence (HR 0.59, 95% CI 0.30–1.15, P = 0.122), but with an increased adjusted risk for DVT recurrence (HR 2.27, 95% CI
1.43–3.60, P<0.001). In the non-cancer stratum, the non-retrieved IVC filter placement was associated
with a decreased risk for PE (HR 0.29, 95% CI 0.09–0.93, P = 0.037), but not with an increased risk for DVT (HR 1.73, 95% CI 0.89–3.38, P = 0.108), while in the active cancer stratum, it was associated with an increased
risk for DVT (HR 2.47, 95% CI 1.24–4.91, P = 0.010), but not with a decreased risk for PE (HR 0.82, 95% CI 0.34-–1.96, P = 0.650).
Conclusions
There were some differences in the risk-benefit balance between VTE patients with
and without active cancer.
Keywords
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Article info
Publication history
Published online: September 10, 2020
Accepted:
September 2,
2020
Received in revised form:
August 8,
2020
Received:
April 19,
2020
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
