RESUMEN
INTRODUCTION: Indwelling inferior vena cava (IVC) filters are associated with complications, and the US Food and Drug Administration recommends their prompt removal when no longer indicated. Therefore, assessing strategies for increasing retrieval rates is warranted. OBJECTIVE: To analyze the variability of IVC filter retrieval rates within our institution based on 2 separate, pre-existing processes in which IVC retrieval is planned for before or after hospital discharge. METHODS: Retrospective chart review was completed for all IVC filters placed in adults between January 2005 and March 2015. Demographics and clinical data related to filter placement and retrieval were abstracted. Patients were classified into 2 groups: patients who had a trauma consultation trauma and nontrauma medical and surgical patients medical. The trauma group patients were subject to a 2-layer tracking process, in which retrieval planning was done before discharge, versus the medical group with a single-layer tracking process and retrieval planning done after discharge. RESULTS: Of the 588 filter placements analyzed, 236 were placed in trauma patients and 352 were placed for medical reasons. The retrieval rate of the entire cohort was 45% (262/588), with the rate among trauma patients more than double that of medical patients (155/236, 66% and 107/352, 30%; respectively, P < 0.0001). CONCLUSION: IVC filter retrieval rate was increased when filter removal was included in discharge planning versus postdischarge tracking. A systematic, multidisciplinary strategic approach to IVC filter management has great potential to improve filter utilization, resource allocation, patient safety, and filter retrieval.
Asunto(s)
Remoción de Dispositivos , Planificación de Atención al Paciente , Filtros de Vena Cava/efectos adversos , Adulto , Anciano , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Alta del Paciente , Estudios RetrospectivosRESUMEN
The basic principles underlying computed tomography, magnetic resonance, and ultrasound are reviewed to promote better understanding of the properties and appropriate applications of these 3 common imaging modalities. A glossary of frequently used terms for each technique is appended for convenience. Risks to patient safety including contrast-induced nephropathy, radiation-induced malignancy, and nephrogenic systemic fibrosis are discussed.
Asunto(s)
Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Ultrasonografía , Contraindicaciones , Medios de Contraste/efectos adversos , Humanos , Neoplasias Inducidas por Radiación/etiología , Dosis de Radiación , Traumatismos por Radiación/etiología , Seguridad , Tomografía Computarizada por Rayos X/efectos adversos , Ultrasonografía/efectos adversosRESUMEN
Spinal cord ischemia is a rare and devastating complication after elective abdominal aortic aneurysm repair. It has recently been reported to occur after endovascular aortic aneurysm repair. We report the first case of delayed neurologic deficit after endovascular aortic aneurysm repair using the Zenith (Cook) device.