Twenty-one-Year Trends in the Use of Inferior Vena Cava Filters

Top Cited Papers
Open Access
Publisher Website
Google Scholar
Abstract
Improved technology in the fabrication of inferior vena cava (IVC) filters has made them less thrombogenic, smaller, easier to insert percutaneously, safer, and in some instances retrievable1-4 and capable of insertion at the bedside.5,6 This has led to a broadening of the indications for insertion.2,7 The generally accepted indications for IVC filter insertion are patients in whom recurrent pulmonary embolism (PE) occurred despite adequate treatment with anticoagulants or in whom anticoagulant therapy is contraindicated.7,8 Additional indications include patients with chronic recurrent PE and pulmonary hypertension and patients undergoing embolectomy or thromboendarterectomy.8 Broader indications (patients with poor cardiopulmonary reserve in whom even a small recurrent PE might be fatal and patients who show a free-floating thrombus in the IVC) now account for 46% to 65% of IVC filter insertions.2 More liberal recommendations by some include prophylaxis in patients with cancer,9 trauma,10,11 burns,12 or acetabular fracture13; hip or knee replacement in patients with a history of thromboembolism14; or prophylaxis in all patients with deep venous thrombosis (DVT) or PE, especially if the patient is older than 65 years.15