A Population-Based Study of the Effectiveness of Inferior Vena Cava Filter Use Among Patients With Venous Thromboembolism

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Abstract
THE PRINCIPAL indications for insertion of an inferior vena cava filter are failure of anticoagulant therapy and a strict contraindication to anticoagulation therapy, such as active bleeding.1 However, an increasing number of vena cava filters are being used in patients with venous thromboembolism who meet less strictly defined indications, such as medically unstable patients, those with a large burden of clot, and patients deemed to be at increased risk for recurrent thromboembolism or anticoagulant-related bleeding.2,3 Further, based on small observational studies from single institutions, some authorities have suggested that use of a filter alone, without anticoagulant therapy, is associated with an equal or lower incidence of adverse outcomes compared with use of a filter plus treatment with heparin sodium followed by warfarin sodium.4