title: Inferior vena cava filters.
abstract: 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.
authors.affiliation: Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Duffett
authors.affiliation: Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Carrier
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001777:Blood Coagulation; D005260:Female; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000401:mortality; D012307:Risk Factors; D016896:Treatment Outcome; D016306:Vena Cava Filters; D054556:Venous Thromboembolism / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants
keywords: hemorrhage; vena cava filters; vena cava, inferior; venous thromboembolism; venous thrombosis