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Review
. 2024 Apr 23;33(2):112-122.
doi: 10.1055/s-0044-1785231. eCollection 2024 Jun.

Contemporary Management of Pulmonary Embolism: Review of the Inferior Vena Cava filter and Other Endovascular Devices

KaChon Lei  1   2 , Michael V DiCaro  2 , Nadia Tak  3 , Scott Turnbull  2 , Ala Abdallah  2 , Tillman Cyrus  1   2   4 , Tahir Tak  1   2   4
Affiliations
Review

Contemporary Management of Pulmonary Embolism: Review of the Inferior Vena Cava filter and Other Endovascular Devices

KaChon Lei et al. Int J Angiol. .

Abstract

Inferior vena cava (IVC) filters and endovascular devices are used to mitigate the risk of pulmonary embolism in patients presenting with lower extremity venous thromboembolism in whom long-term anticoagulation is not a good option. However, the efficacy and benefit of these devices remain uncertain, and controversies exist. This review focuses on the current use of IVC filters and other endovascular therapies in clinical practice. The indications, risks, and benefits are discussed based on current data. Further research and randomized controlled trials are needed to characterize the patient population that would benefit most from these interventional therapies.

Keywords: IVC filter; catheter-based interventions; pulmonary embolism; thrombectomy; thrombolysis.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Comparison of AHA versus ESC risk stratification for pulmonary embolisms. AHA, American Heart Association; ESC, European Society of Cardiology; PESI, Pulmonary Embolism Severity Index.
Fig. 2
Fig. 2
EkoSonic Endovascular Catheter System: the EkoSonic Endovascular Catheter System, including its ultrasonic core and control unit. Courtesy of Boston Scientific, Inc.
Fig. 3
Fig. 3
Bashir Endovascular Catheter : ( a ) the Bashir Endovascular Catheter and a single arm for administration of tPA to the thrombus. ( b ) The Bashir Endovascular Catheter and plus device, with two sidearms allowing for tPA infusion. Courtesy of Thromblex, Inc.
Fig. 4
Fig. 4
Penumbra aspiration thrombectomy system: left images demonstrate both the engine and total thrombectomy system, this system delivers continuous negative pressure (29–98.2 kPa) to remove clots. Right image demonstrates visualization of system on fluoroscopy during a procedure. Courtesy of Penumbra, Inc.
Fig. 5
Fig. 5
FlowTriever System: image above demonstrates the full FlowTriever system. As illustrated a large lumen catheter is guided to a single vessel to remove venous clots. It also utilizes three nitinol mesh disks (bottom left) to disrupt clots and extract them using a mechanical aspiration syringe (top right). Image on the bottom right demonstrates usage of catheter during angiography. Courtesy of Angiodynamic, Inc.
Fig. 6
Fig. 6
AngioVac aspiration system as demonstrated in the figure above, the AngioVac aspiration system consists of a 22F suction cannula with expandable funnel-shaped tip, an extracorporeal circuit with a filter, and a reinfusion catheter for blood return.
Fig. 7
Fig. 7
An illustration of inferior vena cava filter (Greenfield Filter). Manufacturer: Boston-Scientific, Inc.
See this image and copyright information in PMC

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