Inferior Vena Cava Filters—Current Role and Controversies

Abstract

Inferior vena cava filters (IVCFs) remain an indispensable part of an interventionalist's toolbox. Increased recognition of filter-related complications, largely from off-label use and casual approach to filter retrieval, has led to tremendous uncertainty surrounding their use. More stringent regulations on their use and development of newer and safer anticoagulants are gradually changing their role in the management of venous thromboembolism. Herein, the authors review the current role of IVCFs, indications for their use and retrieval, as well as filter-related complications.

Bismuth Nanoparticle and Polyhydroxybutyrate Coatings Enhance the Radiopacity of Absorbable Inferior Vena Cava Filters for Fluoroscopy-Guided Placement and Longitudinal Computed Tomography Monitoring in Pigs

“…2,3 Anticoagulation is the cornerstone of management but for patients with contraindications to anticoagulation, placement of inferior vena cava filters (IVCFs) is used to prevent pulmonary embolism. 4,5 Despite the utility of IVCFs, complications from prolonged dwell of the filter include filter thrombosis, strut penetration, and device fracture. The US Food and Drug Administration conducted a quantitative decision analysis in 2014 of the literature to assess whether there was a time period during which having an IVCF in place outweighed the benefits for patients with a transient risk of pulmonary embolism.…”

“…Venous thromboembolism, with an estimated 1–2 events per 1000 individuals per year, causes 60,000–100,000 deaths annually in the United States . Compared with deep vein thrombosis alone, pulmonary embolism increases the risk of early death 18-fold and is an independent indicator of reduced survival for up to 3 months after onset. , Anticoagulation is the cornerstone of management but for patients with contraindications to anticoagulation, placement of inferior vena cava filters (IVCFs) is used to prevent pulmonary embolism. , Despite the utility of IVCFs, complications from prolonged dwell of the filter include filter thrombosis, strut penetration, and device fracture. The US Food and Drug Administration conducted a quantitative decision analysis in 2014 of the literature to assess whether there was a time period during which having an IVCF in place outweighed the benefits for patients with a transient risk of pulmonary embolism.…”