Indications for Inferior Vena Cava Filter Placement: Do Physicians Comply with Guidelines?

IVC filters—Trends in placement and indications, a study of 2 populations

“…[6] There is a great deal of inconsistency in the recommendations by different societies with relative liberalization of filter use by the Society of Interventional Radiology compared to the American College of Chest Physicians (ACCP). [3,4,7] …”

Indications and Appropriateness of Inferior Vena Cava Filter Placement

“…He also noted a significant difference in compliance with guidelines between internal medicine-trained physicians and non-internal medicinetrained physicians when referring patients for IVC filters. 7 Singh et al 18 analyzed 558 patients using ACCP and Eastern Association for the Surgery of Trauma guidelines; 196 patients received filters outside of guidelines. These authors concluded that IVC filter placement outside of guidelines was not warranted.…”

“…Complications during IVC filter placement include improper positioning (1%-3%), filter migration, caval stenosis, caval occlusion, caval perforation, air embolism, lower extremity edema, access site hematomas (2.2%-4.2%), access site thrombosis (3.8%-4.2%) and access site infections (1%). 7,19,21,22 The PREPIC (Prevention du Risque d'Embolie Pulmonaire par Interruption Cave) study noted an increased incidence of DVT at 2 and 8 years in patients undergoing IVC filter placement. 23,24 The filters reduced the incidence of PE but did not eliminate them, and filters did not reduce mortality.…”

“…2 Approximately 50% of filter placements are in adherence with the current guidelines, and 25% of IVC filters may be placed inappropriately. 7,8 The authors wanted to determine how frequently patients in their hospital had IVC filters placed based on current indications and to compare guidelines published by the American College of Chest Physicians (ACCP) and the Society of Interventional Radiology (SIR). 3,9,10 …”

Implante Simultaneo de Filtro de Veia Cava Inferior e Superior

“…In such cases, placement of an inferior vena cava filter (iVCF) is recommended [10][11][12][13][14] . Insertion of an iVCF is indicated for around 8% of patients with lower limb DVTs and the procedure is considered safe and effective 11,14,15 . Notwithstanding, placement of these devices is reported to have a 5% rate of complications such as fractures, migrations, thrombosis or perforation of the vena cava 11,14,16 and a 5.6% rate of failure to prevent a clinically significant PE 14 .…”