Thromb Haemost 2005; 93(01): 17-22
DOI: 10.1160/TH04-06-0399
Review Article
Schattauer GmbH

Long lives, short indications

The case for removable inferior cava filters
Grace H. Ku
1   Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
,
Henny H. Billett
1   Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
› Author Affiliations
Financial support: The authors have no financial interest in this manuscript.
Further Information

Correspondence to:

Henny Billett, MD
Division of Hematology
Montefiore Medical Center
3411 Wayne Avenue
Bronx, NY 10467, USA
Phone: + 1 718–920–7631   
Fax: + 1 718–882–8698   

Publication History

Received 25 June 2004

Accepted after revision 25 October 2004

Publication Date:
14 December 2017 (online)

 

Summary

Vena cava filters have been in use for decades to prevent pulmonary embolization from deep venous thrombosis. These filters have been shown to be effective, with fairly low rates of filter migration, fracture and thrombosis. However considering that filters remain in situ for the life of the patient and that studies do not show increased longevity in patients with filters, any complications from filters are significant concerns. In addition, often patients require filters for only temporary indications, e.g. contraindication for anticoagulation because of impending procedures, or for only a transient risk period, as in trauma or pregnant patients. In these cases, removable filters may be more appealing. This review will examine the different types of removable filters and the indications in which removable filters may have an advantage over permanent filters.


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  • References

  • 1 Mobin-Uddin K, Smith PE, Martinez LD. et al A vena caval filter for the prevention of pulmonary embolism. Surg Forum 1967; 18: 209-11.
  • 2 Cimochowski GE, Evans RH, Zarins CK. et al Greenfield filter versus Mobin-Uddin umbrella: The continuing quest for the ideal method of vena caval interruption. J Thorac Cardiovasc Surg 1980; 79: 358-65.
  • 3 Ferris EJ, McCowan TC, Carver DK. et al Percutaneous inferior vena caval filters: Follow-up of seven designs in 320 patients. Radiol 1993; 188: 851-6.
  • 4 Streiff MB. Vena caval filters: a comprehensive review. Blood 2000; 95: 3669-77.
  • 5 Greenfield LJ, Proctor MC. Recurrent thromboembolism in patients with vena cava filters. J Vasc Surg 2001; 22: 510-4.
  • 6 Greenfield LJ, McCurdy JR, Brown PP. et al A new intra-caval filter permitting continued flow and resolution of emboli. Surgery 1973; 73: 599-606.
  • 7 Decousus H, Leizorovicz A, Parent F. et al A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. N Engl J Med 1998; 338: 409-15.
  • 8 Rogers FB, Cipolle MD, Velmahos G. et al Practice management guidelines for the prevention of venous thromboembolism in trauma patients: The EAST practice management guidelines work group. J Trauma 2002; 53: 142-64.
  • 9 Millward SF. Temporary and retrievable inferior vena cava filters: Current status. J Vasc Interv Radiol 1998; 9: 31-27.
  • 10 Offner PJ, Hawkes A, Madayag R. et al The role of temporary inferior vena cava filters in critically ill surgical patients. Arch Surg 2003; 138: 591-5.
  • 11 Burbridge BE, Walker DR, Millward SF. Incorporation of the Gunter temporary inferior vena cava filter into the caval wall. J Vasc Intervent Radiol 1996; 7: 289-90.
  • 12 Bauters C, Isner JM. The biology of restenosis. Prog Cardiovasc Dis 1997; 40: 107-16.
  • 13 Hunter DW, Lund G, Rysavy JA. et al Retrieving the Amplatz retrievable filer. Cardiovasc Interv Radiol 1987; 10: 32-6.
  • 14 Roy-Chaudhury P, Kelly BS, Narayana A. et al Hemodialysis vascular access dysfunction from basic biology to clinical intervention. Adv Ren Replace Ther 2002; 9: 74-84.
  • 15 Motwani JG, Topol EJ. Aortocoronary saphenous vein graft disease: Pathogenesis, predisposition, and prevention. Circ 1988; 97: 916-31.
  • 16 Lorch H, Welger D, Wagner V. et al Current practice of temporary vena cava filter insertion: A multicenter registry. J Vasc Intervent Radiol 2000; 11: 83-8.
  • 17 Zwaan M, Lorch H, Kulke C. et al Clinical experience with temporary vena caval filters. J Vasc Intervent Radiol 1998; 9: 594-601.
  • 18 Simon M. Vena cava filters: Prevalent misconceptions. J Vasc Intervent Radiol 1999; 10: 1021-4.
  • 19 Rossi P, Arata FM, Bonaiuti P. et al Fatal outcome in atrial migration of the Tempofilter. Cardiovasc Intervent Radiol 1999; 22: 227-31.
  • 20 Neuerburg JM, Gunther RW, Vorwerk D. et al Results of a multicenter study of the retrievable Tulip vena cava filter: Early clinical experience. Cardiovasc Intervent Radiol 1997; 20: 10-6.
  • 21 Millward SF, Bhargava A, Aquino Jr J . et al Gunther Tulip filter: Preliminary clinical experience with retrieval. J Vasc Intervent Radiol 2000; 11: 75-82.
  • 22 Ponchon M, Goffette P, Hainaut P. Temporary vena caval filtration: Preliminary clinical experience with removable vena caval filters. Acta Clin Belg 1999; 54: 223-8.
  • 23 Greenfield LJ, Proctor MC. Retrievable IVC filters: devices, indications, results. Veith Symposium 2003; VIII: 8.1-8.3.
  • 24 510(k) summary, FDA Maude Data base.
  • 25 Tay K-H, Martin ML, Fry PD. et al Repeated Gunther Tulip inferior vena cava filter repositioning to prolong implantation time. J Vasc Intervent Radiol 2002; 13: 509-12.
  • 26 De Gregorio MA, Gamboa P, Gimeno MJ. et al The Gunther Tulip retrievable filter: prolonged temporary filtration by repositioning within the inferior vena cava. J Vasc Interv Radiol 2003; 14: 1259-65.
  • 27 Asch MR. Initial experience in humans with a new retrievable inferior vena cava filter. Radiol 2002; 225: 835-44.
  • 28 Venbrux AC. The optional (permanent or retrievable) IVC filter: the future of caval interruption. Veith Symposium 2003; III: 5.1-5.4.
  • 29 Lorch H, Zwaan M, Siemens H-J. et al Temporary vena cava filters and ultrahigh streptokinase thrombolysis therapy: A clinical study. Cardiovasc Intervent Radiol 2000; 23: 273-8.
  • 30 Truong TH, Spuentrup E, Staatz G. et al Mechanical thrombectomy of iliocaval thrombosis using a protective expandable sheath. Cardiovasc Intervent Radiol 2004; 27: 254-8.
  • 31 Cope C, Baum RA, Duszak Jr RA . Temporary use of a Bird’s Nest filter during iliocaval thrombolysis. Radiol 1996; 198: 765-7.
  • 32 Geerts WH, Code I K, Jay RM. et al A prospective study of venous thromboembolism after major trauma. New Eng J Med 1994; 331: 1601-6.
  • 33 Sevitt S, Gallagher N. Venous thrombosis and pulmonary embolism: a clinico-pathological study in injured and burned patients. Br J Surg 1961; 48: 475-89.
  • 34 Sevitt S. Fatal road accidents: Injuries, complications, and causes of death in 250 subjects. Br J Surg 1968; 55: 481-505.
  • 35 Owings JT, Kraut E, Battistella F. et al Timing of the occurrence of pulmonary embolism in trauma patients. Arch Surg 1997; 132: 862-6.
  • 36 Shackford SR, Davis JW, Hollingsworth-Fridlund P. et al Venous thromboembolism in patients with major trauma. Am J Surg. 1990; 159: 365-9.
  • 37 Greenfield LJ, Proctor MC, Michaels AJ. et al Prophylactic vena cava filters in trauma: The rest of the story. J Vasc Surg 2000; 32: 490-7.
  • 38 Maxwell RA, Chavarria-Aguilar M, Cockerham WT. et al Routine prophylactic vena cava filtration is not indicated after acute spinal cord injury. J Trauma 2002; 52: 902-6.
  • 39 Rodriguez JL, Lopez JM, Proctor MC. et al Early placement of prophylactic vena caval filters in injured patients at high risk for pulmonary embolism. J Trauma 1996; 40: 797-804.
  • 40 Patton JH, Fabian TC, Croce MA. et al Prophylactic Greenfield filters: Acute complications and longterm follow-up. J Trauma 1996; 41: 231-7.
  • 41 Hughes GC, Smith TP, Eachempati SR. et al The use of a temporary vena caval interruption device in high-risk trauma patients unable to receive standard venous thromboembolism prophylaxis. J Trauma 1999; 46: 246-9.
  • 42 Treffers PE, Huiddekoper BL, Weenik GH. et al Epidemiological observations of thrombo-embolic disease during pregnancy and in the puerperium in 56,022 women. Int J Gynaecol Obstet 1983; 21: 327-31.
  • 43 Mogensen K, Skibsted L, Wadt J. et al Thrombectomy of acute iliofemoral venous thrombosis during pregnancy. Surg Gynecol Obstet 1989; 169: 50-4.
  • 44 Neill AM, Appleton DS, Richards P. Retrievable inferior vena caval filter for thromboembolic disease in pregnancy. Br J Obstet Gynaecol 1997; 104: 1416-8.
  • 45 Neri E, Civeli L, Benvenuti A. et al Protected iliofemoral venous thrombectomy in a pregnant woman with pulmonary embolism and ischemic venous thrombosis. Tex Heart Inst J 2002; 29: 130-2.
  • 46 Ishikawa T, Okabe T, Ogawa K. et al Usefulness of a second temporary vena cava filter for preventing acute pulmonary thromboembolism. Circ J 2003; 67: 718-20.
  • 47 Arnold TE, Karabinis VD, Mehta V. et al Potential of overuse of the inferior vena cava filter. Surg Gynecol Obstet 1993; 177: 463-7.
  • 48 Ginsberg JS. Management of venous thromboembolism. N Engl J Med 1996; 335: 1816-28.
  • 49 Goldhaber SZ. Pulmonary embolism. N Engl J Med 1998; 339: 93-104.
  • 50 Millward SF, Bormanis BE, Markman SJ. et al Preliminary clinical experience with the Gunther temporary inferior vena caval filter. J Vasc Interv Radiol 1994; 5: 863-8.

Correspondence to:

Henny Billett, MD
Division of Hematology
Montefiore Medical Center
3411 Wayne Avenue
Bronx, NY 10467, USA
Phone: + 1 718–920–7631   
Fax: + 1 718–882–8698   

  • References

  • 1 Mobin-Uddin K, Smith PE, Martinez LD. et al A vena caval filter for the prevention of pulmonary embolism. Surg Forum 1967; 18: 209-11.
  • 2 Cimochowski GE, Evans RH, Zarins CK. et al Greenfield filter versus Mobin-Uddin umbrella: The continuing quest for the ideal method of vena caval interruption. J Thorac Cardiovasc Surg 1980; 79: 358-65.
  • 3 Ferris EJ, McCowan TC, Carver DK. et al Percutaneous inferior vena caval filters: Follow-up of seven designs in 320 patients. Radiol 1993; 188: 851-6.
  • 4 Streiff MB. Vena caval filters: a comprehensive review. Blood 2000; 95: 3669-77.
  • 5 Greenfield LJ, Proctor MC. Recurrent thromboembolism in patients with vena cava filters. J Vasc Surg 2001; 22: 510-4.
  • 6 Greenfield LJ, McCurdy JR, Brown PP. et al A new intra-caval filter permitting continued flow and resolution of emboli. Surgery 1973; 73: 599-606.
  • 7 Decousus H, Leizorovicz A, Parent F. et al A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. N Engl J Med 1998; 338: 409-15.
  • 8 Rogers FB, Cipolle MD, Velmahos G. et al Practice management guidelines for the prevention of venous thromboembolism in trauma patients: The EAST practice management guidelines work group. J Trauma 2002; 53: 142-64.
  • 9 Millward SF. Temporary and retrievable inferior vena cava filters: Current status. J Vasc Interv Radiol 1998; 9: 31-27.
  • 10 Offner PJ, Hawkes A, Madayag R. et al The role of temporary inferior vena cava filters in critically ill surgical patients. Arch Surg 2003; 138: 591-5.
  • 11 Burbridge BE, Walker DR, Millward SF. Incorporation of the Gunter temporary inferior vena cava filter into the caval wall. J Vasc Intervent Radiol 1996; 7: 289-90.
  • 12 Bauters C, Isner JM. The biology of restenosis. Prog Cardiovasc Dis 1997; 40: 107-16.
  • 13 Hunter DW, Lund G, Rysavy JA. et al Retrieving the Amplatz retrievable filer. Cardiovasc Interv Radiol 1987; 10: 32-6.
  • 14 Roy-Chaudhury P, Kelly BS, Narayana A. et al Hemodialysis vascular access dysfunction from basic biology to clinical intervention. Adv Ren Replace Ther 2002; 9: 74-84.
  • 15 Motwani JG, Topol EJ. Aortocoronary saphenous vein graft disease: Pathogenesis, predisposition, and prevention. Circ 1988; 97: 916-31.
  • 16 Lorch H, Welger D, Wagner V. et al Current practice of temporary vena cava filter insertion: A multicenter registry. J Vasc Intervent Radiol 2000; 11: 83-8.
  • 17 Zwaan M, Lorch H, Kulke C. et al Clinical experience with temporary vena caval filters. J Vasc Intervent Radiol 1998; 9: 594-601.
  • 18 Simon M. Vena cava filters: Prevalent misconceptions. J Vasc Intervent Radiol 1999; 10: 1021-4.
  • 19 Rossi P, Arata FM, Bonaiuti P. et al Fatal outcome in atrial migration of the Tempofilter. Cardiovasc Intervent Radiol 1999; 22: 227-31.
  • 20 Neuerburg JM, Gunther RW, Vorwerk D. et al Results of a multicenter study of the retrievable Tulip vena cava filter: Early clinical experience. Cardiovasc Intervent Radiol 1997; 20: 10-6.
  • 21 Millward SF, Bhargava A, Aquino Jr J . et al Gunther Tulip filter: Preliminary clinical experience with retrieval. J Vasc Intervent Radiol 2000; 11: 75-82.
  • 22 Ponchon M, Goffette P, Hainaut P. Temporary vena caval filtration: Preliminary clinical experience with removable vena caval filters. Acta Clin Belg 1999; 54: 223-8.
  • 23 Greenfield LJ, Proctor MC. Retrievable IVC filters: devices, indications, results. Veith Symposium 2003; VIII: 8.1-8.3.
  • 24 510(k) summary, FDA Maude Data base.
  • 25 Tay K-H, Martin ML, Fry PD. et al Repeated Gunther Tulip inferior vena cava filter repositioning to prolong implantation time. J Vasc Intervent Radiol 2002; 13: 509-12.
  • 26 De Gregorio MA, Gamboa P, Gimeno MJ. et al The Gunther Tulip retrievable filter: prolonged temporary filtration by repositioning within the inferior vena cava. J Vasc Interv Radiol 2003; 14: 1259-65.
  • 27 Asch MR. Initial experience in humans with a new retrievable inferior vena cava filter. Radiol 2002; 225: 835-44.
  • 28 Venbrux AC. The optional (permanent or retrievable) IVC filter: the future of caval interruption. Veith Symposium 2003; III: 5.1-5.4.
  • 29 Lorch H, Zwaan M, Siemens H-J. et al Temporary vena cava filters and ultrahigh streptokinase thrombolysis therapy: A clinical study. Cardiovasc Intervent Radiol 2000; 23: 273-8.
  • 30 Truong TH, Spuentrup E, Staatz G. et al Mechanical thrombectomy of iliocaval thrombosis using a protective expandable sheath. Cardiovasc Intervent Radiol 2004; 27: 254-8.
  • 31 Cope C, Baum RA, Duszak Jr RA . Temporary use of a Bird’s Nest filter during iliocaval thrombolysis. Radiol 1996; 198: 765-7.
  • 32 Geerts WH, Code I K, Jay RM. et al A prospective study of venous thromboembolism after major trauma. New Eng J Med 1994; 331: 1601-6.
  • 33 Sevitt S, Gallagher N. Venous thrombosis and pulmonary embolism: a clinico-pathological study in injured and burned patients. Br J Surg 1961; 48: 475-89.
  • 34 Sevitt S. Fatal road accidents: Injuries, complications, and causes of death in 250 subjects. Br J Surg 1968; 55: 481-505.
  • 35 Owings JT, Kraut E, Battistella F. et al Timing of the occurrence of pulmonary embolism in trauma patients. Arch Surg 1997; 132: 862-6.
  • 36 Shackford SR, Davis JW, Hollingsworth-Fridlund P. et al Venous thromboembolism in patients with major trauma. Am J Surg. 1990; 159: 365-9.
  • 37 Greenfield LJ, Proctor MC, Michaels AJ. et al Prophylactic vena cava filters in trauma: The rest of the story. J Vasc Surg 2000; 32: 490-7.
  • 38 Maxwell RA, Chavarria-Aguilar M, Cockerham WT. et al Routine prophylactic vena cava filtration is not indicated after acute spinal cord injury. J Trauma 2002; 52: 902-6.
  • 39 Rodriguez JL, Lopez JM, Proctor MC. et al Early placement of prophylactic vena caval filters in injured patients at high risk for pulmonary embolism. J Trauma 1996; 40: 797-804.
  • 40 Patton JH, Fabian TC, Croce MA. et al Prophylactic Greenfield filters: Acute complications and longterm follow-up. J Trauma 1996; 41: 231-7.
  • 41 Hughes GC, Smith TP, Eachempati SR. et al The use of a temporary vena caval interruption device in high-risk trauma patients unable to receive standard venous thromboembolism prophylaxis. J Trauma 1999; 46: 246-9.
  • 42 Treffers PE, Huiddekoper BL, Weenik GH. et al Epidemiological observations of thrombo-embolic disease during pregnancy and in the puerperium in 56,022 women. Int J Gynaecol Obstet 1983; 21: 327-31.
  • 43 Mogensen K, Skibsted L, Wadt J. et al Thrombectomy of acute iliofemoral venous thrombosis during pregnancy. Surg Gynecol Obstet 1989; 169: 50-4.
  • 44 Neill AM, Appleton DS, Richards P. Retrievable inferior vena caval filter for thromboembolic disease in pregnancy. Br J Obstet Gynaecol 1997; 104: 1416-8.
  • 45 Neri E, Civeli L, Benvenuti A. et al Protected iliofemoral venous thrombectomy in a pregnant woman with pulmonary embolism and ischemic venous thrombosis. Tex Heart Inst J 2002; 29: 130-2.
  • 46 Ishikawa T, Okabe T, Ogawa K. et al Usefulness of a second temporary vena cava filter for preventing acute pulmonary thromboembolism. Circ J 2003; 67: 718-20.
  • 47 Arnold TE, Karabinis VD, Mehta V. et al Potential of overuse of the inferior vena cava filter. Surg Gynecol Obstet 1993; 177: 463-7.
  • 48 Ginsberg JS. Management of venous thromboembolism. N Engl J Med 1996; 335: 1816-28.
  • 49 Goldhaber SZ. Pulmonary embolism. N Engl J Med 1998; 339: 93-104.
  • 50 Millward SF, Bormanis BE, Markman SJ. et al Preliminary clinical experience with the Gunther temporary inferior vena caval filter. J Vasc Interv Radiol 1994; 5: 863-8.