Prophylactic Inferior Vena Cava Filters: Do They Make a Difference in Trauma Patients?

Abstract

PIVCF increased significantly without impacting the overall PE rate. There was a 1.6% PE rate among PIVCF, high retrieval rate (59%), low complication rate (0.1%), and satisfactory compliance with traditional EAST guidelines.

Prevention of Venous Thromboembolism in Individuals with Spinal Cord Injury: Clinical Practice Guidelines for Health Care Providers, 3rd ed.

“…The rate of IVC filter insertion in trauma patients has increased exponentially, in large part related to the greater use of retrievable filters (Antevil, 2006;Shackford, 2007;Cherry, 2008;Spate, 2008;Yunus, 2008;Knudson, 2011). However, there is wide variation in IVC filter insertion rates across trauma centers, which cannot be accounted for by patient VTE risk.…”

“…In fact, there are no randomized trials of IVC filter use as primary thromboprophylaxis in any patient group. Numerous studies and a meta-analysis of prospective studies report no difference in the rates of PE among trauma patients with and without a prophylactic IVC filter (Velmahos, 2000:140;Girard, 2003;Antevil, 2006;Shackford, 2007;Cherry, 2008;Knudson, 2011;Kidane, 2012). Another meta-analysis reported a reduction in PE (but not in mortality) in trauma patients with use of prophylactic IVC filters; the number needed to treat to prevent one nonfatal PE with IVC filters was between 109 and 962 .…”

“…The use of prophylactic IVC filters in trauma patients has not been shown to reduce overall mortality or PE-related mortality (Wojcik, 2000;Antevil, 2006;Cherry, 2008;Singh, 2013;. A systematic review of prospective studies found no difference in the rates of PE among trauma patients with and without prophylactic IVC filters (Velmahos, 2000:140).…”

“…There is also no evidence that filters are necessary in patients managed in trauma units with a policy to provide the best thromboprophylaxis that currently can be offered. In addition, IVC filters have not been shown to be cost-effective (Maxwell, 2002;Cherry, 2008;Spangler, 2010). Spangler et al performed cost-effectiveness analyses on use of prophylactic IVC filters and concluded that filters were neither cost-effective nor effective over the reasonable range of assumption probabilities (Spangler, 2010).…”

“…A systematic review of prospective studies found no difference in the rates of PE among trauma patients with and without prophylactic IVC filters (Velmahos, 2000:140). Furthermore, patients with an IVC filter still develop PE and occasionally have fatal PE (Giannoudis, 2007;Cherry, 2008).…”