Is there enough evidence to support the use of inferior vena caval filters?—No.
The inferior vena caval (IVC) filter is a widely available medical device that has been used for decades to prevent pulmonary embolism (PE), but studies testing the device have not demonstrated adequate proof of efficacy. Venous thromboembolism (VTE) is the third most common vascular disease after myocardial infarction and stroke, while nearly 1 million patients are diagnosed as having fatal or nonfatal PE annually in the United States and Europe combined. Inferior vena caval filters first received approval by the US Food and Drug Administration (FDA) in 1976, the year the FDA was assigned by Congress to regulate medical devices. The approval came with little supervision on the efficacy of these devices, and the devices have remained FDA-approved ever since. The approval of retrievable filters, with theoretical safety advantages but little proof of net benefit, further fueled the use of IVC filters. Recent evidence indicates that 1 in 6 Medicare beneficiaries with PE receive an IVC filter for secondary prevention.1 The global market of IVC filters should exceed $430 million in 2016.
Bikdeli B, Ross JS, Krumholz HM. Data Desert for Inferior Vena Caval Filters: Limited Evidence, Supervision, and Research. JAMA Cardiol. 2017;2(1):3–4. doi:10.1001/jamacardio.2016.3764
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