REVIEWS   

Italian Journal of Vascular and Endovascular Surgery 2016 September;23(3):160-70

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Inferior vena cava filters: contemporary evidence and outcomes

Auréline BOITET, Becky LONG, Efthymios D. AVGERINOS, Rabih A. CHAER

Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

Venous thromboembolism (VTE) is a major cause of morbidity and mortality. Inferior vena cava filters (IVCFs) are usually indicated in patients with acute VTE and a contraindication to anticoagulation, a complication or a failure of anticoagulation. The past two decades, the use of IVCFs increased with the development of retrievable filters for both therapeutic and prophylactic indications, the latter remaining controversial because of the lack of randomized and controlled trials. The results of the different studies are contradictory in trauma and obese patients. In cancer patients, the systematic use of IVCF treatment with acute VTE is not supported because of the increased rate of VTE rate and bleeding and the limited benefit due to their low short-term survival. In VTE thrombolysis, the use of IVCF is also not recommended. Retrievable filters have good results but the retrieval rate remains low and complications may be more common compared to the permanent filters; their use should be limited for short-term indications. New bioresorbable filter introduce an innovative concept, interesting for short-term indications, eliminating the disadvantages of a permanent filter and avoiding the risk of a second intervention for retrieving the filter. The current review summarizes the guidelines and updates on the prophylactic indications for IVCF placement, the use of retrievable filters and the new biodegradable filter.