Developing a clinical prediction model and analyzing risk factors linked to the challenge of eliminating extended recovery window filters

Abstract Objective: To investigate the clinically significant risk factors for problematic inferior vena cava filter (IVCF) removal with a long retrieval window and to create a clinical model. Methods: Patients who had IVCF removal and IVCF type with lengthy recovery window IVCF in the Third Hospital of Hebei Medical University's vascular surgery department between June 2022 and June 2024 were gathered with routine anticoagulation prior to surgery. A total of 372 patients—211 men and 161 women—with ages ranging from 18 to 87 years and a mean age of 58.47 ± 13.32 years were enrolled in the study. Of them, 185 had Denali IVCF, 87 Octoparms IVCF, and 100 Option IVCF. In order to determine the independent risk factors for the difficulty of removing IVCFs from a long recovery window, univariate and multivariate logistic regression analysis were used. A columnar graphical model was built to internally validate the predictive efficacy and calibration of the model using the area under the curve (AUC) of the subject's work characteristics (ROC), calibration curve, and decision curve (DCA). The independent risk factors were examined using univariate and multivariate logistic regression analyses. Results: A risk prediction model for difficulty in removing IVCF was constructed after a multifactorial logistic regression analysis revealed that IVCF tilt angle, retention time, common iliac vein-IVC angle, and IVC width were independent risk factors for difficulty in removing IVCF with a prolonged retrieval window. Internal validation of the model revealed that the calibration curves were near the ideal curves; the ROC curve for the training set had an AUC of 0956, and the ROC curve for the validation set had an AUC of 0.985. Conclusion: The clinical risk prediction model built using these risk factors is useful in predicting the difficulty of removing IVCFs with prolonged retrieval windows and has clinical guidance value. IVCF tilt angle, retention time, common iliac vein-IVC angle, and IVC width are independent risk factors for difficulty in removing IVCFs with prolonged retrieval windows.