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OBJECTIVE: Despite the widespread use of inferior vena cava filters (IVCFs), no large controlled trials have examined the IVCF retrieval rates and clinical events for patients without retrieved IVCFs. We hypothesized that IVCF retrieval success would decrease as the time from placement increased and that the clinical event rates would be more prevalent for those without a retrieved IVCF. We evaluated retrieval success as a function of time and compared the rates of venous thromboembolism and mortality between patients who had undergone IVCF retrieval within 12 months vs patients with unsuccessful IVCF retrieval. METHODS: All patients who had undergone IVCF placement between 2011 and 2017 with available follow-up data at eight community hospitals were enrolled in our retrospective cohort study. The procedure dates, incidence of subsequent deep vein thrombosis (DVT) and pulmonary embolism, and mortality dates were collected. Patients were classified as having a nonretrieved IVCF if their IVCF had not been retrieved after ≥12 months of follow-up. RESULTS: Of 1709 patients who had undergone IVCF placement, IVCF retrieval was successful for 770. We found a significant (P = .018) decrease in retrieval success as the time from IVCF insertion increased. After a mean of 36 ± 16 months, the incidence of subsequent DVT was lower in the retrieved group than in the nonretrieved group (8.1% vs 11.9%; P = .05; hazard ratio, 0.65; 95% confidence interval, 0.42-1.00). Mortality was lower for those with retrieved than for those without retrieved IVCFs (8.8% vs 28.8%; P < .001; hazard ratio, 0.5; 95% confidence interval, 0.35-0.7). No significant difference was found in the rate of pulmonary embolism. CONCLUSIONS: IVCF nonretrieval was more likely for older patients with a greater prevalence of comorbid conditions. Increased rates of subsequent DVT and mortality were observed for patients without IVCF retrieval. Finally, the likelihood of successful IVCF retrieval decreased with increased time from IVCF placement.

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Introduction: Given the known association between sugar-sweetened beverage (SSB) intake and poorer health, we instituted an educational curriculum to reduce student consumption of SSBs. Methods: The program included third- to fifth-grade students. A simple demonstration using teaspoons of sugar or small candies showed students the quantity of added sugar in common beverages. This amount of sugar was compared to the daily limit recommended by the American Heart Association. Key principles were reinforced over a 4-month period. Anonymous beverage recall surveys were distributed to 213 students at baseline and 211 students 6 months after exposure to the curriculum. Primary endpoints included evaluation of SSB, real fruit juice (RFJ), diet soda, and water servings in the last 24 hours. Results: The proportion of children consuming 2 or more beverages daily decreased from 8.9% to 4.3% (P = .0546) for diet soda, from 70.0% to 58.3% (P = .0123) for SSB + RFJ, and from 60.1% to 47.4% (P = .0087) for SSB. At baseline, students reported an average consumption of 3.5 SSB, 4.5 SSB + RFJ, 0.4 diet soda, and 3.3 water servings per day. At 6 months after exposure, the average daily beverage consumption decreased to 2.7 servings per day for SSB (P = .014), 3.8 for SSB + RFJ (P = .039), and 0.2 for diet soda (P = .027). Water consumption increased from 3.3 to 3.6 servings per day (P = .075). Discussion: Our data suggest grade school students are receptive to information about the adverse effects of SSBs on health. Adding similar educational programs to elementary school curriculum may help reduce long-term SSB consumption.

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BACKGROUND: Predictors of target lesion revascularization (TLR) have not been well defined in patients undergoing peripheral percutaneous interventions (PPI). In this study we analyze predictors of TLR in a consecutive cohort of patients from two medical centers. METHODS: Data were extracted from a prospectively collected peripheral vascular registry. Of 105 consecutive patients (175 vessels) undergoing PPI, follow up was achieved in 104 patients (172 vessels) at 8.06 +/- 4.51 months. Univariate analysis was performed between the groups with (n = 19, vessels = 25) and without (n = 85, vessels = 147) TLR. Logistic regression analysis was utilized to model for the predictors of TLR. RESULTS: TLR occurred in 14% of vessels treated at 8.06 +/- 4.51 months. By univariate analysis, vessels with TLR on follow up had longer treated segments (167.0 +/- 139.16 mm vs. 98.49 +/- 113.33 mm; p = 0.027), more severe lesions (91.96 +/- 12.56% vs. 85.51 +/- 14.43%; p = 0.037) and were younger (63.0 +/- 10.1 years vs. 69.1 +/- 11.1 years; p = 0.032). Also, there was a trend toward a higher hs-CRP (11.35 +/- 17.85 vs. 7.45 +/- 9.57 mg/L) and more total occlusions (44.0% vs. 22.6%) in the TLR group, but these did not reach statistical significance. Logistic regression analysis with backward elimination including all these variables showed that younger age (p = 0.007), female gender (p = 0.033) and treated vessel length (p = 0.028) were the only independent predictors of TLR. CONCLUSIONS: Younger age, female gender and longer treated vessel length are independent predictors of TLR in patients undergoing PPI. The cost-effectiveness in treating these patients with PPI versus surgery needs to be defined in future studies.

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