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Inferior vena cava filters: current best practices

Abstract

Venous thromboembolism (VTE) is a common cause of inpatient and outpatient morbidity and mortality. While anticoagulant therapy is considered the primary means of prevention and treatment of VTE, inferior vena cava filters (IVCFs) are often used as an alternative or adjunct to anticoagulation. With the advent of retrievable filters indications have liberalized, to include placement for primary prophylaxis in high-risk patients. However, this practice is based on limited evidence supporting their efficacy in preventing clinically relevant outcomes. Since indiscriminate use of IVCFs can be associated with net patient harm and increased health care costs, knowledge of the literature surrounding IVCF utilization is critical for providers to adopt best practices. In this review, we will provide an overview of the literature as it relates to specific clinical questions that arise when considering IVCF utilization in the prevention and treatment of VTE. Practice-based recommendations will be reviewed to provide the clinician with guidance on challenging clinical scenarios.

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Conflict of interest

Anita Rajasekhar has funding from the American Society of Hematology. She has past involvement on physician advisory boards for Octapharma, Baxter, Bayer and Alexion. She has no other financial interests to disclose.

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Correspondence to Anita Rajasekhar.

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Rajasekhar, A. Inferior vena cava filters: current best practices. J Thromb Thrombolysis 39, 315–327 (2015). https://doi.org/10.1007/s11239-015-1187-5

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Keywords

  • Inferior vena cava filter
  • Deep venous thrombosis
  • Venous thromboembolism
  • Pulmonary embolism
  • Anticoagulation