IVC Filters in Integrated Acute Pulmonary Embolism Management-A Narrative Review

Area of Science:

• Cardiology
• Interventional Radiology
• Vascular Surgery

Background:

• Acute pulmonary embolism (APE) is a major cause of death and illness, even with increased deep venous thrombosis (DVT) prophylaxis.
• Inferior Vena Cava (IVC) filters are devices used to prevent APE by trapping clots from the lower body.

Purpose of the Study:

• To review the indications, outcomes, complications, and retrieval considerations for IVC filter placement in managing APE.

Main Methods:

• Review of current literature and guidelines regarding IVC filter use.
• Analysis of meta-analyses on IVC filter placement efficacy and risks.
• Summary of early and delayed complications associated with IVC filters.

Main Results:

• IVC filters reduce subsequent APE risk but increase DVT risk, with no significant impact on APE-related or all-cause mortality.
• Procedural complications include bleeding, infection, and vascular injury; delayed complications involve filter migration, fracture, and IVC occlusion or thrombosis.
• Current guidelines favor IVC filter placement for specific therapeutic indications, especially when anticoagulation is contraindicated.

Conclusions:

• IVC filter deployment is crucial for interventional APE management within strict indications.
• Retrieval of temporary IVC filters should be considered once anticoagulation is safe.
• Risk-benefit assessment is vital for IVC filter placement and retrieval decisions.