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August 11, 1997

Indications for Inferior Vena Cava Filters

Author Affiliations

Charleston, SC

Arch Intern Med. 1997;157(15):1770-1771. doi:10.1001/archinte.1997.00440360216029

I would appreciate it if Pacouret et al1 would comment on the management of patients with proximal deep vein thrombosis who underwent thrombolysis for pulmonary embolism. There were 67 such patients excluded from their study for this reason. I would like to know if the protocol used at Trousseau University Hospital, Tours, France, includes inferior vena cava placement before thrombolysis. Some authors recommend that a temporary inferior vena cava filter be inserted before thrombolytic therapy is initiated, especially if the thrombus is floating or extends into the inferior vena cava. The filter is placed to prevent migration of partially lysed thrombi.2,3 The introduction of new temporary inferior vena cava filters can liberalize the indications for filter placement. These filters can be easily placed and retrieved percutaneously, even after neointimal formation.4 They can be removed within a few hours or days after thrombolysis, after lysis of most captured

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