Vena caval filters for the prevention of pulmonary embolism

Abstract

a This population was reported by PREPIC2. All participants also received anticoagulation. b We downgraded certainty by one step due to some imprecision and risk of bias concerns (low numbers of events and open-label study design). c Major bleeding was defined as bleeding that contributed to death; occurred at a critical site (e.g. intracranial, intraspinal, epidural, or lung haemorrhage); led to transfusion of 2 or more units of red cells, platelets, or fresh frozen plasma; or was associated with a decrease in the haemoglobin level of more than 2 grams per decilitre within any 24 hour period a er injury (Schulman 2005). Summary of findings 2. Retrievable vena caval filters with anticoagulation compared to anticoagulation for prevention of PE following multiple traumatic injuriesDoes the use of vena caval filters prevent PE in people who have sustained multiple trauma? Patient or population: participants who sustained multiple traumatic injuries a Settings: hospital Intervention: retrievable VCF (with anticoagulation and IPC) b Comparison: no VCF (with anticoagulation and IPC) Anticipated absolute effects* (95% CI) Outcomes Risk with no VCF, with an-Risk with VCF, with anticoag-Relative risk (95% CI) No of Participants (RCTs) Certainty of the evidence (GRADE) Comments Cochrane Library Trusted evidence. Informed decisions. Better health.

Ibero-American Society of Interventionism (SIDI) and the Spanish Society of Vascular and Interventional Radiology (SERVEI) Standard of Practice (SOP) for the Management of Inferior Vena Cava Filters in the Treatment of Acute Venous Thromboembolism

“…Recently, a Cochrane systematic review concluded, of the six identified randomized studies, one did not show significant evidence in the placement of an IVCF in the first three months regarding PE, DVT, severe bleeding, and mortality, and another study also showed no benefit in PE and mortality for patients with prophylactic IVCF placement in polytraumatized patients. The remaining four studies presented no firm conclusions regarding filter efficacy in the prevention of PE, suggesting the necessity of further trials to determine the efficacy of IVCFs [ 42 ].…”

The use of pre-operative Inferior Vena Cava filters for thromboprophylaxis in ultra-high-risk patients undergoing total hip and knee arthroplasty: a systematic review and narrative analysis

“…In 2006, the British Committee for Standards in Haematology concluded that no particular IVCF design had proven superiority, but that removable filters should be used [53]. A Cochrane review in 2010 [54] documented that only two randomised controlled trials (RCTs) fulfilled the inclusion criteria [55,56] and that, although there were large case series reporting long-term experience of IVCFs for various indications, none of which included UHRAPs, no firm judgements could be made and no recommendations given for other subgroups of patients, as they had not been studied in any RCTs. In accordance with other studies, it was concluded that large RCTs, of at least two years duration, were required to investigate the indications for IVCFs in high-risk patients, the timing of insertion and removal, short and long-term complications and a comparison of permanent versus retrievable filters, including subgroup analyses of various filter brands [26,32,38,40,45,52].…”

Case report: Cement entrapped in the inferior vena cava filter after pedicle screw augmentation

“…It is well known that implantation of IVC filter is effective in the prevention or reduction of the risk of fatal PE in patients with high risk of lower extremity deep vein thrombosis ( 12 ). In rare cases, some IVC filters have also been used as a prevention strategy against cement emboli in IVC, which may migrate into the pulmonary circulation ( 13 , 14 ).…”