Update on inferior vena cava filters

The ravages of thromboembolic disease continue to plague patients despite improvements in diagnostic imaging and anticoagulation regimens. In certain cases, standard medical therapy for thromboembolism is contraindicated, results in complications, or fails to adequately protect patients from embolic insults. These patients are treated with insertion of inferior vena cava (IVC) filters. Although it appears that IVC filters do reduce long-term pulmonary embolism (PE) rates, there may be a higher associated incidence of IVC thrombosis and lower-extremity deep venous thrombosis (DVT) than with anticoagulation alone. This article will address attributes of the theoretical ideal IVC filter, recently introduced IVC filters, complications of use of IVC filters, and results of recent IVC filter studies. Alternative sites for filter placements are then reviewed, along with use of temporary and retrievable IVC filters and use of IVC filters for prophylactic situations.