Optional filters have presented both versatility and challenge to the management of VTE in high-risk patients. An underlying concern about the quintessential efficacy of IVCFs lingers on, while the impact of lost follow-ups in young patients is still at large. Class 1 studies on optional filters would add certainty to the use of this generation of filters, be a step forward in relevance from the seminal work of Decousus and garner the willingness needed to engage teamwork and institutional proactiveness against loopholes such as lost follow-ups that can undermine the portrayed benefits of a potentially lifesaving device.

No abstract

In 2008 the vast majority of IVCFs were inserted for prophylaxis in trauma patients. To increase the number of retrieved IVCFs, responsibility for the removal should be clarified in every hospital. The indications, advantages, safety and also the design of IVCFs are still under debate. A randomized controlled trial is needed to determine the appropriate use and indications for this potentially useful device in trauma patients.

The fact that many inferior vena cava filters (IVCF) in trauma patients are not being removed has been described numerous times in the literature, but nobody really gives a reason why. This case presents a young patient who prophylactically received an optional IVCF after sustaining severe multitrauma. He had a failed retrieval 8 weeks post insertion and consequently was lost to follow-up before a second removal attempt was performed. Institutions inserting IVCF should establish guidelines for following up patients receiving prophylactic IVCF.