Use of Inferior Vena Cava (IVC) Filters (bsh 2006)

Potential Indications

 

To prevent PE in patients with VTE who have a contraindication to anticoagulation (AC)

Selected patients who develop PE despite AC (Alt preferred, e.g. Higher INR target)

 

Pregnant patients with a contraindication to AC

Pregnant patients with a VTE <2 weeks prior to delivery

 

Pre-op patients with VTE <1 month ago in whom AC must be stopped

Prior to pulmonary endartectomy

 

Not an indication

 

Unselected patients with VTE who can have AC

Free floating thrombus

Thrombolysis

 

Filters

 

The only purpose is to prevent PE, & actually increases risk of DVT.

 

Complications

 

Immediate:      Misplacement, pneumothorax, haematoma, air embolus, arteriovenous fistula

Early:              Insertion site thrombus (8.5%), infection

Late:                DVT (21%), IVC thrombus (2-10%), post-thrombotic syndrome, filter migration