# A cross-sectional analysis of all vena cava filter placement over 9-years in Brazil: trends and mortality rates in a population of over 200 million

## TL;DR

This study analyzes vena cava filter placement trends and mortality in Brazil over nine years, highlighting disparities between public and private healthcare systems.

## Contribution

The study provides the first nationwide analysis of vena cava filter use in Brazil’s dual healthcare system.

## Key findings

- The private sector performed 57% of vena cava filter procedures despite covering only 25% of the population.
- The Southeast region accounted for 70% of private procedures and 40.5% of public procedures.
- Mortality rates were similar between public and private systems (6.7% vs. 7.4%).

## Abstract

•The private sector performs the majority of procedures despite serving a minority of the population.•National procedure volume more than doubled (140% increase) in almost a decade.•The Southeast region is responsible for 70% of all private procedures.

The private sector performs the majority of procedures despite serving a minority of the population.

National procedure volume more than doubled (140% increase) in almost a decade.

The Southeast region is responsible for 70% of all private procedures.

Venous Thromboembolism (VTE) is a major global health concern, with Vena Cava Filters (VCFs) serving as an alternative to anticoagulation in high-risk patients. Brazil’s VCF trends remain understudied, particularly in its dual public-private healthcare system. This database study allows a broad overview of the Brazilian healthcare landscape.

This cross-sectional nationwide analysis used Brazilian public (SUS/TabNet) and private (ANS/D-TISS) healthcare databases (2015–2023) to assess VCF placement rates, regional disparities, and in-hospital mortality. Data included 21,630 procedures, analyzed via generalized linear models (Gamma/Poisson distributions).

The private system performed 57% of VCFs (12,323) despite covering only 25% of the population, with a 4.25-fold higher procedure rate per capita than the public system (29.45 vs. 6.42 per-million). Women accounted for 57.8% of recipients. The Southeast region dominated (70% private, 40.5% public), while the North and Midwest had the lowest rates. Mortality rates were comparable (public 6.7% vs. private 7.4%, p = 0.066), peaking during COVID-19. Procedure volumes rose 140% over 9-years, contrasting with declining U.S. trends post-FDA restrictions.

Brazil’s VCF use reflects systemic disparities, with private-system overrepresentation and regional gaps. This study enables unprecedented insights into large-scale VCF implementation across diverse healthcare subsystems.