Vena cava filters for management of venous thromboembolism: a clinical review

Abstract

Venous thromboembolism (VTE) is the common cause of morbidity and mortality. Vena cava filters (VCF) represent an important alternative to anticoagulation for management of VTE. VCF use has increased dramatically with the availability of retrievable filters. Since indiscriminate use of VCF can be associated with net patient harm, knowledge of the risks and benefits of these devices is essential to optimal evidence-based practice. In this review, we will examine the characteristics of available permanent and optional VCF, their efficacy and safety in management of VTE and discuss appropriate, extended and unsubstantiated indications for VCF use. We will also review the clinical outcomes of VCF in alternative placement sites (supra-renal inferior vena cava and superior vena cava) and in specialized patient populations (bariatric surgery, cancer, etc.), recommendations regarding anticoagulation for prevention of thrombosis as well as recommended follow up for patients with VCF.

Keywords: Anticoagulation; Deep venous thrombosis; Inferior vena cava filter; Pulmonary embolism; Venous thromboembolism.