Users' questions

Is anticoagulation needed with IVC filter?

Is anticoagulation needed with IVC filter?

Anticoagulation should be resumed in patients with an IVC filter once contraindications to anticoagulation or active bleeding complications have resolved (class I). Patients who receive retrievable IVC filters should be evaluated periodically for filter retrieval within the specific filter’s retrieval window (class I).

When are vena cava filters indicated?

An absolute indication for IVC filter placement is the presence of DVT or PE with any of the following conditions: Contraindication for anticoagulation. Recurrent PE in spite of anticoagulation. Anticoagulation-related complication.

Does IVC filter prevent PE?

Bottom line. Permanent inferior vena cava (IVC) filters, used with anticoagulation, decrease the risk of pulmonary embolism (PE) while increasing the risk of recurrent deep vein thrombosis (DVT).

Can you get a pulmonary embolism with an IVC filter?

DVT—deep vein thrombosis, IVC—inferior vena cava, PE—pulmonary embolism. For permanent filters, research has shown that breakthrough PE—despite the IVC filter—occurred in 0% to 6.2% of cases. One randomized controlled trial 10 showed that PE occurred in 15.1% of high-risk patients who did not receive IVC filters.

Which is better inferior vena cava or anticoagulation filter?

Mismetti P, Laporte S, Pellerin O, et al. Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. JAMA 2015;313:1627-35.

When do you need a vena cava filter?

Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC (Prevention du Risque d’Embolie Pulmonaire par Interruption Cave) randomized study. Circulation 2005;112:416-22.

When to use IVC filter in PE patients?

The available data today supports circumspect use of IVCF in patients that cannot receive systemic anticoagulation, and on a case-by-case basis for patients with poor cardiopulmonary reserve particularly if they cannot receive more advanced rescue therapies like thrombolysis or if they are undergoing embolectomy for acute PE.

Which is the only universally accepted indication for IVCF placement?

The only universally accepted indication for IVCF placement remains patients with an acute thromboembolism and an absolute contraindication to anticoagulation. 10-16 Table 1: Guideline Recommendations Regarding the Use of Inferior Vena Cava Filters