Deep vein thrombosis IVC filter

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Inferior vena cava (IVC) filter is not indicated for the treatment of deep vein thrombosis (DVT) unless the patient has contraindications to anticoagulation therapy due to an elevated risk of bleeding. Anticoagulation therapy should be initiated when the bleeding risk subsides.^[1]

Class I
"1. Adult patients with any acute proximal DVT (or acute PE) with contraindications to anticoagulation or active bleeding complication should receive an IVC filter (Level of Evidence: B)"
"2. Anticoagulation should be resumed in patients with an IVC filter once contraindications to anticoagulation or active bleeding complications have resolved (Level of Evidence: B)."
"3. Patients who receive retrievable IVC filters should be evaluated periodically for filter retrieval within the specific filter's retrieval window (Level of Evidence: C)."

Class III (No Benefit)
"1. An IVC filter should not be used routinely in the treatment of iliofemoral DVT (Level of Evidence: B)."

Class IIa
"1. For patients with recurrent PE despite therapeutic anticoagulation, it is reasonable to place an IVC filter (Level of Evidence: C)."
"2. For iliofemoral DVT patients who are likely to require permanent IVC filtration (eg, long-term contraindication to anticoagulation), it is reasonable to select a permanent nonretrievable IVC filter device (Level of Evidence: C)."
"3. For iliofemoral DVT patients with a time-limited indication for an IVC filter (eg, a short-term contraindication to anticoagulant therapy), placement of a retrievable IVC filter is reasonable (Level of Evidence: C)."

Class IIb
"1. For patients with recurrent DVT (without PE) despite therapeutic anticoagulation, it is reasonable to place an IVC filter(Level of Evidence: C)."

↑ Kearon C, Akl EA, Comerota AJ; et al. (2012). "Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 141 (2 Suppl): e419S–94S. doi:10.1378/chest.11-2301. PMID 22315268. Unknown parameter |month= ignored (help)
↑ ^2.0 ^2.1 Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ; et al. (2011). "Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association". Circulation. 123 (16): 1788–830. doi:10.1161/CIR.0b013e318214914f. PMID 21422387.