Inferior vena cava filters – An overview,

Sasank Kalipatnapu, Sunil Agarwal
Department of Vascular Surgery, Christian Medical College, Vellore, Tamil Nadu, India

Date of Web Publication

16-Jul-2019

Correspondence Address:
Dr. Sasank Kalipatnapu
Department of Vascular Surgery, Christian Medical College, Vellore - 632 002, Tamil Nadu
India

Source of Support: None, Conflict of Interest: None

  Abstract 

Inferior Vena Cava Filters have been proven to prevent pulmonary embolism in patients with deep venous thrombosis with contraindications for anticoagulation. This short review aims to provide an overview of the current indications and guidelines for the usage of these devices.

Keywords: Inferior vena cava filters, pulmonary embolism, venous clots

How to cite this article: Kalipatnapu S, Agarwal S. Inferior vena cava filters – An overview. Curr Med Issues 2019;17:10-1

How to cite this URL: Kalipatnapu S, Agarwal S. Inferior vena cava filters – An overview. Curr Med Issues [serial online] 2019 [cited 2019 Jul 17];17:10-1. Available from: http://www.cmijournal.org/text.asp?2019/17/1/10/262824

Introduction

Inferior vena cava (IVC) filters form an important part of the armamentarium in vena caval interruption. Their primary role is to prevent pulmonary embolism and not to treat or prevent venous clots.^[1]

Types and Designs of Inferior Vena Cava Filters

The earliest design of an IVC filter was a silicon membrane with multiple holes, known as the Mobin-Uddin filter named after the scientist who designed it.^[2] The original Greenfield filter with the conical design introduced in 1973 has remained the design standard for successive decades. Today, several designs of IVC filters are also available in the market, including conical designs, double-helical designs, and double-basket type. In addition, filters can be broadly divided into four different types, as shown in [Table 1].

Table 1: Types of filters Click here to view

Indications of Inferior Vena Cava Filters

Today, a plethora of devices are available in the market from several manufacturers. Although their primary use was interventional in patients who could not be anticoagulated, there has been an increase in the use of these devices for prophylactic indications. This can be attributed to the growing body of knowledge and skill with endovascular techniques and the safety profile of these devices.^[3] However, in every patient, it would be prudent to regard the benefits and harms prior to making the decision of an IVC filter insertion. The host of clinical decision-making pathways can be grouped into three categories – indications backed by evidence, relative expanded indications, and contraindications. These are listed in [Table 2].^[1]

Table 2: Indications and contraindications for inferior vena cava filters* Click here to view

Conclusions

Current ACCP guidelines recommend against the use of IVC filters in any patient who can receive therapeutic anticoagulation.^[4] While the mortality benefit of IVC filters is debatable at best, their role in the prevention of pulmonary embolism has been established.^[1] The indications and use of vena caval filters are still on the rise. With novel devices such as Angel Catheter currently entering the market, new avenues are opening up for the prophylactic use of filters in critically ill patients.^[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 

References

1.	Passman MA. Vena cava interruption. In: Sidawy AN, Perler BA, editors. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia: Elsevier; 2018.
2.	Mobin-Uddin K, Jude JR. Intracaval prosthesis for prevention of pulmonary embolism. Br J Surg 1969;56:620.
3.	DeYoung E, Minocha J. Inferior vena cava filters: Guidelines, best practice, and expanding indications. Semin Intervent Radiol 2016;33:65-70.
4.	Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest 2016;149:315-52.
5.	Angel Catheter. Bio2 Medical. Available from: https://bio2medical.com/angel-catheter/. [Last accessed on 2018 Oct 18].