The Need for Anticoagulation Following Inferior Vena Cava Filter Placement: Systematic Review
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To perform a systemic review to determine the effect of anticoagulation on the rates of venous thromboembolism (pulmonary embolus, deep venous thrombosis, inferior vena cava (IVC) filter thrombosis) following placement of an IVC filter.
A comprehensive computerized literature search was performed to identify relevant articles. Data were abstracted by two reviewers. Studies were included if it could be determined whether or not subjects received anticoagulation following filter placement, and if follow-up data were presented. A meta-analysis of patients from all included studies was performed. A total of 14 articles were included in the final analysis, but the data from only nine articles could be used in the meta-analysis; five studies were excluded because they did not present raw data which could be analyzed in the meta-analysis. A total of 1,369 subjects were included in the final meta-analysis.
The summary odds ratio for the effect of anticoagulation on venous thromboembolism rates following filter deployment was 0.639 (95% CI 0.351 to 1.159, p = 0.141). There was significant heterogeneity in the results from different studies [Q statistic of 15.95 (p = 0.043)]. Following the meta-analysis, there was a trend toward decreased venous thromboembolism rates in patients with post-filter anticoagulation (12.3% vs. 15.8%), but the result failed to reach statistical significance.
Inferior vena cava filters can be placed in patients who cannot receive concomitant anticoagulation without placing them at significantly higher risk of development of venous thromboembolism.
KeywordsAnticoagulation Evidence-based medicine IVC filters Venous interruption
- 3.http://www.consort-statement.org/ (accessed May 2006)
- 4.Sutton AJ, Abrams KR, Jones DR, Sheldon TA, Song F (2000) Methods for meta-analysis in medical research. Wiley, New York, pp 58–63Google Scholar
- 13.Lang W, Schweiger H, Hofmann-Preiss K (1992) Results of long-term venacavography study after placement of a Greenfield vena caval filter. J Cardiovasc Surg 33:573–578Google Scholar
- 24.Ballew KA, Philbrick JT, Becker DM (1993) Vena cava filter devices. Clin Chest Med 16:295–305Google Scholar
- 32.Castellani L, Nicaise H, Peietri J, Quilliet L, Desvaux B, Alison D (1987) Transvenous interruption of the inferior vena cava: New model of vena cava filter. Preliminary results in 35 cases. Int Angiol 6:299–306Google Scholar
- 41.Sandercock P, Mielke O, Liu M, Counsell C (2006) Anticoagulants for preventing recurrence following presumed non-cardioembolic ischaemic stroke or transient ischaemic attack. The Cochrane Database of Systematic Reviews 2:1–31Google Scholar