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Endovascular Intervention Reduces Thrombosis Risk in Retrievable Inferior Vena Cava Filters: A Multicenter

Xiao-Nan Wang1, Hao Zhang1, Xiao-Ye Li1

  • 1Department of Vascular Surgery, Changhai Hospital, Navy (Second) Military Medical University, Shanghai, China.

Annals of Vascular Surgery
|April 12, 2026
PubMed

Insights

Endovascular intervention (EI) for deep vein thrombosis (DVT) significantly reduces retrievable inferior vena cava filter (RIVCF) thrombosis risk. This suggests selective RIVCF use may prevent complications, challenging routine filter placement before EI.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Current guidelines recommend retrievable inferior vena cava filters (RIVCF) before endovascular intervention (EI) for deep vein thrombosis (DVT).
  • The impact of EI on RIVCF-related thrombosis/trapped embolus (T/TE) remains controversial.

Purpose of the Study:

  • To evaluate the effect of endovascular intervention (EI) on the incidence of RIVCF-related thrombosis/trapped embolus (T/TE).
  • To assess the necessity of routine RIVCF placement prior to EI for DVT.

Main Methods:

  • Prospective registry-based study of 2,773 patients undergoing RIVCF placement across 103 Chinese centers (2018-2019).
  • Patients stratified into EI (n=1,472) and no-EI (n=1,301) groups, propensity-score matched (1:1) to balance baseline variables.
  • Primary endpoint: RIVCF T/TE, validated by core-lab adjudicated imaging (CT/angiography).

Main Results:

  • After matching (n=1,007 per group), EI was associated with a 46% lower risk of RIVCF T/TE (8.9% vs. 14.0%, P<0.001).
  • Symptomatic pulmonary embolism rates were comparable between groups (1.2% vs. 2.8%, P=0.07).
  • No significant brand-specific differences in T/TE incidence were observed (P=0.32).

Conclusions:

  • Endovascular intervention (EI) reduces the risk of RIVCF-related thrombosis/trapped embolus (T/TE).
  • Routine RIVCF placement prior to EI may not be necessary for all DVT patients.
  • Selective filter use could potentially spare patients from device-related complications.
Abstract

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