Inferior vena cava filters: a framework for evidence-based use

Area of Science:

• Vascular Medicine
• Interventional Radiology
• Cardiology

Background:

• Venous thromboembolism (VTE) is a significant cause of illness and death.
• Inferior vena cava filters (IVCFs) are an alternative to anticoagulation for specific VTE patients.
• The use of retrievable IVCFs has increased significantly, broadening indications despite limited supporting evidence.

Purpose of the Study:

• To review current trends in IVCF utilization.
• To examine evidence-based recommendations for IVCF use in diverse clinical situations.
• To assess the risks, benefits, and retrieval indications of IVCFs.

Main Methods:

• Literature review of IVCF trends and clinical practice.
• Analysis of indications for IVCF placement and retrieval.
• Evaluation of complications associated with indwelling IVCFs.

Main Results:

• IVCF use has expanded, with indications liberalized beyond established evidence.
• Absolute contraindications to anticoagulation are agreed indications for IVCFs.
• Primary VTE prophylaxis with IVCFs in high-risk patients lacks strong literature support.

Conclusions:

• Indiscriminate IVCF use may lead to patient harm.
• Understanding the risks and benefits of IVCFs is crucial for evidence-based practice.
• Careful patient selection and consideration of retrieval are essential for optimal IVCF management.