An expert spotlight on inferior vena cava filters

Inferior Vena Cava Filters: An Overview

“…Indications for IVC filter placement can be split into three main categories: classic, expanded, and prophylactic. 6,13 The classic indication for placement is the presence of a VTE with an absolute or relative contraindication to anticoagulation. 6,13 Absolute contraindications include active bleeding, recent intracranial hemorrhage, platelet count < 50,000/uL, and planned procedure with high bleeding risk.…”

“…6,13 The classic indication for placement is the presence of a VTE with an absolute or relative contraindication to anticoagulation. 6,13 Absolute contraindications include active bleeding, recent intracranial hemorrhage, platelet count < 50,000/uL, and planned procedure with high bleeding risk. 5,7 Relative contraindications include recurrent gastrointestinal bleeds, presence of intracranial or spinal tumors, and platelet count < 150,000/uL.…”

“…7 Professional societies such as the American Heart Association, the American College of Radiology, and the Society of Interventional Radiology agree on these indications (Table 1). 6,7,13 Though a true prospective randomized controlled trial testing the efficacy of IVC filters is unlikely to occur (since it would be unethical to require a control group not to receive intervention in the setting of VTE), a few retrospective and observational studies show a reduction in fatal PEs with filter placement. 6,8,13 Also, general consensus is that patients who have failed or experienced a major complication to anticoagulation also fall under the classic indication for IVC filter placement.…”

Nano‐embedded medical devices and delivery systems in interventional radiology

“…Inferior vena cava filters (IVCFs), first introduced in 1973, were designed to trap venous emboli from the lower extremity and prevent clinically significant PE (Duffett & Carrier, 2017). IVCF placement is indicated in patients with venous thromboembolism (VTE) who cannot be given anticoagulants, patients who have VTE and are already on anticoagulant therapy, and patients without VTE but who are considered high risk because of underlying clinical disease (Pillai et al, 2021). Throughout the years, different models of IVCFs have been made available, most of which are placed percutaneously and removed after a few months (retrievable).…”

“…In 2003, the U.S. Food and Drug Administration (FDA) cleared retrievable IVCFs for clinical use as permanent implants, although these devices were originally designed for endovascular retrieval (Grewal et al, 2020). This resulted in an exponential increase in the use of retrievable IVCFs but subsequently caused low retrieval rates of only 8.5%, with patients being lost to follow-up (Grewal et al, 2020;Pillai et al, 2021). Non-retrieval of IVCF may cause further complications, which include vessel perforation, thrombophlebitis, and thrombosis (Perez, Jacobsen, et al, 2021;PREPIC, 2005).…”