A review of inferior vena cava filters

Abstract

The care of patients with venous thromboembolism (VTE) is delivered via a multidisciplinary team. The primary treatment for VTE is anticoagulation however, placement of filter devices in the inferior vena cava (IVC) to prevent embolization of deep venous thrombosis (DVT) is a well-established secondary treatment option. However, many controversies remain regarding utilization and management of filters.

Endovascular Therapies Using Catheter-Based Thrombectomy or Catheter-Directed Thrombolysis for Acute Non-Cancer Associated Inferior Vena Cava Thrombosis: A Retrospective Cohort Study

“…Hence, IVCT may carry a greater risk of lethal PE, and placing a filter may be considered given the more extensive and possible free-floating thrombus. 22 In the present study, we found 33.0% of patients with IVCT had suffered from concomitant PE. Temporary filters were inserted into the IVC above or below the renal vein in 54.7% of patients with extensive thrombus or thrombus exceeding through the tip of the original IVCF that were evaluated as potentially life-threatening prior to further treatments.…”

“…Although acute IVCT is less frequently identified, its related complications are significant and alarming. 22 The GARFIELD-VTE trail demonstrated that IVCT patients had a higher risk of allcause mortality rate (13.28% vs 4.91%) compared to those patients who underwent LEDVT. 24 Alkhouli et al 17 found that patients treated with CDT had a 1.62-fold higher rate of inhospital PE than those who underwent anticoagulation, and Nagarsheth et al 14 found that patients who suffered from postprocedure PE may have benefited from a temporary filter.…”

“…13 Besides that, complications including filter migration (<1%), fractures (2%-10%), and IVC wall or adjacent organ perforation (0%-41%) have also been observed. 22 Ahmad et al 4 conducted a follow-up study of 1718 cases who underwent IVCF placement, revealing the incidence of IVCF-related thrombosis reached up to 18%. In the present study, we found that the indwelling IVCFs were the major risk factor fostering the required IVCT, which accounted for the majority (56.6%) of IVCT cases.…”

Use of the Protrieve sheath to trap embolizing thrombus during a complex mechanical thrombectomy procedure with a thrombosed inferior vena cava filter

“… 4 Embolized thrombus can accumulate within IVC filters as designed; nonetheless, thrombogenicity can also contribute to filter thrombosis. 1 The risk of PE in cases of thrombosed IVC filters has limited treatment options and led to temporary filters often remaining unretrieved. A systematic review reported that only 34.9% of retrievable IVC filters placed for a temporary indication had been removed.…”

“…Placement of an inferior vena cava (IVC) filter is indicated when patients are at high risk for pulmonary embolism (PE) and have either cardiopulmonary comorbidities or anticoagulation contraindications. 1 The aim of IVC filter placement is to prevent embolized thrombus from reaching the pulmonary arteries. However, the benefit of filters for PE occurrence has remained unresolved.…”