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Inferior vena cava filter placement and removal

  • 06

    By Jose Rodriguez, Contributor to Vein News and www.VeinsVeinsVeins.com 


    What is a vena cava filter?

    An inferior vena cava (IVC) filter is a small device that can stop blood clots from going up into the lungs. It is implanted in the vena cava below the levelof the renal veins. 

    Who gets vena cava filters?

    Patients with deep vein thrombosis who can have complications from anticoagulation with the use of blood thinners may benefit from a vena cava filter.  This may include someone who has bleeding in the brain from a trauma or fall, or has bleeding in the digestive tract.

    Researchers conduced a study in a tertiary hospital in Russia to see what the indictions for vena cava filter placement was, death rates related to the vena cava filter and incidence of post implantation filter occlusion. 

    2399 patients with venous thromboembolism were admitted to the hospital. 442 (18.4%) received an inferior vena cava filter.

    Retrievable models were used in most cases (98.8%).

    In 119 patients (5%), cava filters were used due to contraindications for anticoagulation, while in 184 (7.7%), anticoagulation was not effective and thrombosis progression was documented by Doppler US imaging. 

    101 (4.2%) patients received an inerior vena cava filter due to high risk for developing pulmonary embolism.

    What were the risk factors for developoing pulmonary embolism in this study?

    PE risk (length of floating thrombus ≥7 cm, in proximal location) and pulmonary hypertension on echocardiography were indications to implant inferior vena cava filters  38 patients (1.6%).

    Other risk factors were p atients with deep vein thrombosis (DVT) in combination with pulmonary embolism (PE).

    What were the results of this study?

    1) Overall mortality rate after infertior vena cava filter insertion was 0.2%.

    2) No fatal pulmonary embolism was found with the use of vena cava filters.

    3) Occlusion of vena cava filters was 4.8% in this series. 

    4) 1.2% of patients were readmitted electively for removal of vena cava filters.

    What are the conclusions of this study? 

    One in five patients with proximal DVT and/or PE receivesd inferior vena caval filter.

    The most common indications for inferior vena cava filter implantation were inability for anticoagulation or anticoagulation failure. 

    Citation:  Arslanbekov MM, Efremova OI, Lebedev IS, Kirienko Ai and Zolotukhin IA. Inferior vena cava filter utilization in patients with venus thromboembolism:  Analysis of a database of a tertiary hospital.  Phlebology 2020; December 13 (online publication).