Journal
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
Volume 15, Issue 1, Pages 3-12Publisher
WILEY
DOI: 10.1111/jth.13564
Keywords
hemorrhage; vena cava filters; vena cava; inferior; venous thromboembolism; venous thrombosis
Categories
Funding
- New Investigator Award from the Heart and Stroke Foundation of Canada
- Tier 2 Research Chair in Thrombosis and Cancer
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Use of inferior vena cava (IVC) filters has increased dramatically in recent decades, despite a lack of evidence that their use has impacted venous thromboembolism (VTE)-related mortality. This increased use appears to be primarily driven by the insertion of retrievable filters for prophylactic indications. A growing body of evidence, however, suggests that IVC filters are frequently associated with clinically important adverse events, prompting a closer look at their role. We sought to narratively review the current evidence on the efficacy and safety of IVC filter placements. Inferior vena cava filters remain the only treatment option for patients with an acute (within 2-4 weeks) proximal deep vein thrombosis (DVT) or pulmonary embolism and an absolute contraindication to anticoagulation. In such patients, anticoagulation should be resumed and IVC filters removed as soon as the contraindication has passed. For all other indications, there is insufficient evidence to support the use of IVC filters and high-quality trials are required. In patients where an IVC filter remains, regular follow-up to reassess removal and screen for filter-related complications should occur.
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