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The need for anticoagulation following inferior vena cava filter placement: systematic review

Charles E Ray1, Allan Prochazka

  • 1Department of Radiology, University of Colorado Denver and Health Sciences Center, Denver, Colorado, USA. charles.ray@uchsc.edu

Cardiovascular and Interventional Radiology
|December 18, 2007
PubMed

Insights

Anticoagulation after inferior vena cava (IVC) filter placement does not significantly reduce venous thromboembolism (VTE) rates. Patients can receive IVC filters without increased VTE risk, even if anticoagulation is not possible.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiology

Background:

  • Inferior vena cava (IVC) filters are used to prevent pulmonary embolism in patients at high risk.
  • The role of anticoagulation in preventing VTE after IVC filter placement is not well-defined.

Purpose of the Study:

  • To systematically review and meta-analyze the effect of anticoagulation on VTE rates following IVC filter placement.

Main Methods:

  • A comprehensive literature search identified 14 studies.
  • Data from 9 studies (1,369 patients) were included in the meta-analysis.
  • VTE rates were compared between patients with and without post-filter anticoagulation.

Main Results:

  • The odds ratio for VTE with anticoagulation was 0.639 (p=0.141), indicating no statistically significant effect.
  • A trend towards decreased VTE rates (12.3% vs. 15.8%) was observed with anticoagulation, but did not reach statistical significance.
  • Significant heterogeneity was noted among the included studies.

Conclusions:

  • IVC filters can be safely placed in patients who cannot receive anticoagulation.
  • These patients are not at a significantly higher risk of developing VTE.
  • The findings support the use of IVC filters even in the absence of anticoagulation therapy.
Abstract

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