LAUSR

Inferior vena cava (IVC) filters are recommended in patients with extensive lower extremity thromboembolism with contraindications to anticoagulation, including visceral bleeding, trauma, elective surgery and pregnancy. There is an increase in the complication rates on attempted filter retrieval beyond the recommended time frame of indwelling filters, which include failure of retrieval, device infection, IVC filter fracture and migration, thrombus formation, and IVC occlusion and perforation [1]. Hence, the British Society of Radiologists (BSIR) and United States Food and Drug Administration (US-FDA) have issued guidelines that recommend retrieval of temporary IVC filters in all patients within 9 weeks [2]. However, there is global evidence of poor temporary IVC retrieval rates, with means ranging from as low as 8 to 45% [1]. The main recurring causes remain poor patient follow-up following IVC filter insertion, lack of awareness and education amongst the referring clinicians [3]. Different management strategies have been implemented to ensure improved retrieval rates, including a multidisciplinary team approach involving the interventional radiologists (IR), referring clinicians and haematologists, as well as introducing a dedicated IR follow-up clinic or dedicated IR nurses and databases to ensure the filters are removed in a timely fashion [4]. There has also been continued discussion regarding the overall responsibility for ensuring the retrieval of the IVC filters [5]. Some suggest that this responsibility should solely lie with the referring clinicians, while others believe the IR consultant responsible for the filter insertion should be wholly responsible. Various methods are currently in practice to prompt clinicians to ensure requests are in place for the retrieval of the filters, which include specific instructions in the IVC filter insertion radiology reports and/or discharge summaries for the removal of the IVC filter within the time frame. This survey aims to obtain a snapshot of the current practices and estimated retrieval rates within various institutions in the UK. All BSIR members were invited by email to complete an online survey consisting of a single questionnaire in December 2017. Respondents were asked to provide estimated rates of retrieval according to the local institutional audit results and detail further explanation regarding the overall responsibility and the current practice of the IVC filter retrieval in their institution. The respondents were grouped into two categories depending on whom the IVC filter retrieval responsibility lain upon, IR team or referring clinicians. The attempted retrieval rates were divided into three groups: 75–100, 50–75 and \ 50%. Data collected from the survey were analysed to establish observations and associations between the current local practices and the overall retrieval rates. Fifty-seven respondents [interventional radiology (IR) consultants] from various institutions of district general hospitals and tertiary centres completed the survey. Thirtysix respondents had dedicated policies for the IR team to & Permesh Singh Dhillon [email protected]