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Ryan M. KIEFER, William S. STAVROPOULOS
Division of Interventional Radiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
Inferior vena cava (IVC) filters have become a commonly used medical device for protection from pulmonary embolism (PE). Despite their increasing frequency of use, rigorous evidence to support their benefit and safety is limited and the appropriateness of their indications is debated among physicians and professional societies. There is currently general consensus that filter use in adult patients with acute thromboembolic disease and a known contraindication to anticoagulation is acceptable, however, use for prophylactic indications remains controversial. This article reviews recent evidence for the use of IVC filters for prophylactic protection from PE and in special patient populations. Few randomized control trials exist for filter use and they fail to show consistent benefit in patients who are anticoagulated. Much of the evidence for filter use comes from observational studies with varying findings of effectiveness and safety. In patients with IVC filters, careful follow up and timely retrieval if the filter is no longer required is recommended.