Vena Cava Filters: Why, When, What, How?

Abstract

Peoria, IL; Lackland Airforce Base, 7X; and Chicago, IL Pulmonary emboli, a potentially lethal venous thromboembolic complication, is a potentially preventable morbidity or mortality that surgeons should consider in the perioperative period or in high-risk patients. Prophylactic inferior vena cava (IVC) filter placement offers a high protection rate against fatal pulmonary emboli. This manuscript discusses the indications for filter placement, different types of currently available IVC filters, and problems and complications of filter placement and vena cava filters. Optional or retrievable IVC filters are also discussed. Overall, individual patient's clinical risks and benefits should be considered before vena cava filter placement. The new generation of optional filters may offer clinicians a new option of temporal risk reduction without the long-term complications that can be associated with permanent IVC filters.

Rates and Predictors of Plans for Inferior Vena Cava Filter Retrieval in Hospitalized Patients

“…Complications of filter placement include immediate issues such as problems with filter positioning, filter tilting, and technical malfunctions. 21 In addition, IVC filters increase the risk for later deep venous thrombosis 5,6 as well as rarer complications such as insertion site thrombosis, 22 perforation of the inferior vena cava, 22,23 and filter migration to the heart or lungs. 24,25 These complications highlight the importance of ensuring timely removal of filters in appropriate patients.…”

Concurrent prophylactic placement of inferior vena cava filter in gastric bypass and adjustable banding operations in the Bariatric Outcomes Longitudinal Database

“…8,32 Additionally, IVC filters are not completely protective for PE. 24,33 Although there are studies investigating the outcomes of IVC filter placement in the bariatric patient population, most of these studies are not randomized and are underpowered to confirm a significant difference in the rates of PE and related outcomes with and without prophylactic IVC filters. 8,14,28,34 They are also of limited follow-up in a patient population with a reasonably long life expectancy.…”

“…9,13,24,25,33,37 Conversely, our study analyzed BOLD, the largest prospective longitudinal database available and a very well maintained comprehensive repository of bariatric surgery patient information from centers across the United States. 7,16,17 However, a common criticism of such large administrative data resources is lack of specificity.…”

Biotextiles as vena cava filters

“…17.3). 10 With respect to their fi ltering ability against emboli, the basket, and multilayered designs are considered more effi cient than the conical design. 11…”