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Published on: July 20, 2022
Complications of inferior vena cava filters
Simer Grewal1, Murthy R Chamarthy1, Sanjeeva P Kalva1
1Department of Radiology, Division of Interventional Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Insights
Inferior vena cava (IVC) filters offer pulmonary embolism prophylaxis for deep venous thrombosis patients unsuitable for anticoagulation. Understanding IVC filter complications is crucial for risk-benefit assessment.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiology
Background:
- Inferior vena cava (IVC) filter placement is a key prophylaxis for pulmonary embolism in deep venous thrombosis patients.
- Increasing IVC filter implantation trends necessitate a comprehensive understanding of associated risks.
- The advent of retrievable filters introduced new complications requiring careful consideration.
Purpose of the Study:
- To review and categorize complications associated with IVC filters.
- To analyze differences in complications among various IVC filter device types, including retrievable filters.
- To outline clinical presentations, prevention, and treatment strategies for IVC filter complications.
Main Methods:
- Systematic review of literature on IVC filter complications.
- Categorization of complications into procedure-related, post-procedure, and retrieval-related.
- Description of device-specific differences and retrievable filter complications.
Main Results:
- Complications are categorized into procedural, post-procedural, and retrieval phases.
- Limited prospective studies hinder detailed comparison between device types.
- Clinical presentations, prevention, and treatment strategies are detailed for each complication.
Conclusions:
- A thorough understanding of IVC filter limitations and complications is essential for informed clinical decision-making.
- Despite modern design improvements, vigilance regarding potential adverse events remains critical.
- Further prospective studies are needed to better elucidate device-specific risks and outcomes.
Abstract:
Inferior vena cava (IVC) filter placement is a relatively low risk alternative for prophylaxis against pulmonary embolism in patients with pelvic or lower extremity deep venous thrombosis who are not suitable for anticoagulation. There is an increasing trend in the number of IVC filter implantation procedures performed every year. There are many device types in the market and in the early 2000s, the introduction of retrievable filters brought an additional subset of complications to consider. Modern filter designs have led to decreased morbidity and mortality, however, a thorough understanding of the limitations and complications of IVC filters is necessary to weight the risks and benefits of placing IVC filters. In this review, the complications associated with IVC filters are divided into procedure related, post-procedure, and retrieval complications. Differences amongst the device types and retrievable filters are described, though this is limited by a significant lack of prospective studies. Additionally, the clinical presentation as well as prevention and treatment strategies are outlined with each complication type.
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