Inferior vena cava filters: recent controversies

Get off my back! Inferior vena cava filter erosion into the lumbar spine

“…As a result, the Federal Drug Administration recommends that both retrievable and permanent filters be removed within 59 days of insertion once the risk for pulmonary embolism has resolved 6 9. In our case, the discovery of a retained IVCF more than 2 years after its original insertion was not surprising as retrieval rates of filters has not matched the uptick in their insertion 6. In our case, due to the complexity of the surgery and her comorbidities, she was discharged on anticoagulation with outpatient follow-up with her vascular surgeon to further discuss safe IVCF removal.…”

“…Such contraindications include active gastrointestinal bleed (as in our patient’s history), cerebral haemorrhage and haemorrhagic stroke among others 4. There are two major types: retrievable and permanent 6. Since their introduction in the late 1990’s, the placement of retrievable IVCFs has risen in part due to reportedly lower complication rates than permanent filters, which associated with an increased incidence of recurrent DVTs, filter migration, caval wall perforation, thrombosis, infection, pulmonary emboli and filter fracture 2 4–9.…”

“…Despite limited evidence supporting their ability to truly prevent life-threatening pulmonary emboli, and association instead, with recurrent DVTs, IVCFs continue to be placed in patients with absolute contraindications to anticoagulation 10 11. As a result, the Federal Drug Administration recommends that both retrievable and permanent filters be removed within 59 days of insertion once the risk for pulmonary embolism has resolved 6 9. In our case, the discovery of a retained IVCF more than 2 years after its original insertion was not surprising as retrieval rates of filters has not matched the uptick in their insertion 6.…”

“…There are two major types: retrievable and permanent 6. Since their introduction in the late 1990’s, the placement of retrievable IVCFs has risen in part due to reportedly lower complication rates than permanent filters, which associated with an increased incidence of recurrent DVTs, filter migration, caval wall perforation, thrombosis, infection, pulmonary emboli and filter fracture 2 4–9. Despite limited evidence supporting their ability to truly prevent life-threatening pulmonary emboli, and association instead, with recurrent DVTs, IVCFs continue to be placed in patients with absolute contraindications to anticoagulation 10 11.…”