Key result
The use of inferior vena cava filters continues to rise despite little change in guidelines, and their prophylactic use remains controversial pending randomized controlled trials.
The prophylactic use of IVC filters remains controversial and requires randomized controlled trials in specific patient populations to justify their increasing use.
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Prophylactic IVC filter use warrants caution; leaves open benefit in select high-risk groups pending RCTs.
PURPOSE OF REVIEW: The purpose of this review was to examine recent studies concerning the use of inferior vena cava (IVC) filters. RECENT FINDINGS: In the past 18 months, the American College of Chest Physicians released the 9th edition of their guideline for the prevention and treatment of venous thromboembolism. There have also been a number of studies reviewing the use of IVC filters in select populations for the prophylactic prevention of pulmonary embolism. Trauma continues to be the leading indication for prophylactic filters in a number of series, but further studies have demonstrated some benefit of prophylactic filters in the bariatric and spine surgery populations. The IVC filter complication rate remains low; however, so does the retrieval rate for potentially removable filters. These retrieval rates are increased with use of dedicated patient tracking mechanisms. Finally, there have been a number of technology updates in the hardware itself, focusing on strut design. SUMMARY: Despite little change in the society guidelines, the use of vena cava filters (VCFs) continues to rise. Overall, the use of IVC filters, especially in prophylactic situations, will remain controversial until randomized, controlled trials are performed within each specific patient population.
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Sing et al. (2013) conducted a review in Venous thromboembolism. Inferior vena cava filters was evaluated. The use of inferior vena cava filters continues to rise despite little change in guidelines, and their prophylactic use remains controversial pending randomized controlled trials.
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