Why the study?
To present an interventional radiology standard of practice on the use of inferior vena cava filters in patients with or at risk to develop venous thromboembolism.
What are the consensus-based absolute, relative, and prophylactic indications for inferior vena cava filter placement and retrieval in patients with or at risk for venous thromboembolism?
What are the consensus-based absolute, relative, and prophylactic indications for inferior vena cava filter placement and retrieval in patients with or at risk for venous thromboembolism?
Answers are grounded in this paper and cite their sources.
This SIDI and SERVEI clinical practice guideline establishes formal interventional radiology consensus restricting IVCF use primarily to acute VTE with anticoagulation contraindications or bleeding, rejecting prophylactic use, and mandating prompt retrieval when no longer clinically needed.
OBJECTIVES: to present an interventional radiology standard of practice on the use of inferior vena cava filters (IVCFs) in patients with or at risk to develop venous thromboembolism (VTE) from the Iberoamerican Interventional Society (SIDI) and Spanish Vascular and Interventional Radiology Society (SERVEI). METHODS: a group of twenty-two interventional radiologist experts, from the SIDI and SERVEI societies, attended online meetings to develop a current clinical practice guideline on the proper indication for the placement and retrieval of IVCFs. A broad review was undertaken to determine the participation of interventional radiologists in the current guidelines and a consensus on inferior vena cava filters. Twenty-two experts from both societies worked on a common draft and received a questionnaire where they had to assess, for IVCF placement, the absolute, relative, and prophylactic indications. The experts voted on the different indications and reasoned their decision. RESULTS: a total of two-hundred-thirty-three articles were reviewed. Interventional radiologists participated in the development of just two of the eight guidelines. The threshold for inclusion was 100% agreement. Three absolute and four relative indications for the IVCF placement were identified. No indications for the prophylactic filter placement reached the threshold. CONCLUSION: interventional radiologists are highly involved in the management of IVCFs but have limited participation in the development of multidisciplinary clinical practice guidelines.
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Gregorio et al. (2021) studied Acute venous thromboembolism (VTE). Inferior vena cava filter (IVCF) placement and retrieval vs. Not placing IVCF or permanent vs. retrievable filters was evaluated on Expert consensus (100% agreement threshold) on absolute, relative, and prophylactic indications for IVCF placement and retrieval. Twenty-two interventional radiology experts reached 100% consensus on two absolute indications for inferior vena cava filter placement (anticoagulation contraindication or bleeding) and unanimous agreement against prophylactic use.
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