The role of vena caval filters in the management of venous thromboembolism

Abstract

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality worldwide. Anticoagulation is the preferred treatment for VTE, however, in selected patient populations, the risk of bleeding from anticoagulation outweighs its benefit. For these patients, alternative methods of pulmonary embolism (PE) prevention are needed. In 1865, Armand Trousseau proposed the concept of vena caval interruption. This idea has evolved from surgical ligation of the inferior vena cava (IVC) to the development of percutaneous IVC filters, and most recently, retrievable filters. With these advances in technology, there has been a dramatic increase in the use of IVC filters. Despite the vast number of reports on the use of IVC filters, there are limited data on their efficacy in many clinical circumstances. In this review, we will discuss the currently available IVC filters, data on their efficacy and safety and our assessment of appropriate indications for their use.