Data on use, trend, and predictors of inferior vena cava filters (IVCF) stem from the United States. No European data is available. We did a nationwide, patient-level, epidemiological analysis of the Swiss Medical statistic including all patients receiving IVCF during hospitalization for primary or secondary venous thromboembolism (VTE) prevention in Switzerland from 2003 to 2022. Additionally, we aimed to study the retrieval rate of IVCF.

Patients were retrieved using VTE-specific ICD-10 codes and procedure codes for IVCF placement and retrieval. We gave a descriptive overview of the clinical presentation of patients with IVCF placement. We calculated the prevalence of IVCF placement in PE patients, the in-hospital case fatality rate of patients with IVCF, and the rate of IVCF retrieval for IVCF placed between January and April, due to missing traceability of individual patients into the following year.

IVCF placement was recorded in 4,812 inpatients (20.1% for primary VTE prevention). External (traumatic) causes of morbidity and cardiovascular diseases, including VTE, were the most prevalent comorbidities in patients with IVCF placement. Intracerebral haemorrhage was documented in 438 (9.1%) patients. The prevalence of IVCF placed out of all hospitalizations increased over time: from 0.4 per 10,000 hospitalizations in 2003 to 2.3 per 10,000 hospitalizations. Since 2010, this increase has mainly been driven by secondary prevention in VTE patients; Figure 1. The prevalence of IVCF in PE patients increased with increasing hospital size: in university hospitals, the prevalence was 41.5 per 1,000 hospitalizations, whereas in major regional hospitals the prevalence was 12.7 per 1,000 hospitalizations. A total of 431 (9%) of IVCF patients died during index hospitalization. For patients with IVCF as secondary prevention, the median retrieval rate was 29.2% (IQR: 25.9%-30.8%). For patients with IVCF as primary prevention the median rate was 32.3% (IQR: 27.7%-50.3%); Figure 2.

We showed an increasing trend of IVCF placement among patients with acute VTE, whereas a stable rate was documented among patients without VTE. The overall IVCF retrieval rate decreased over time and did not appear to exceed 40%, indicating that logistical, technical, or medical barriers prevent retrieval, even in patients with retrievable IVCF.