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January 2017

A Measured Approach to Vena Cava Filter Use—Respect Rather Than Regret

Author Affiliations
  • 1Harvard Medical School, Boston, Massachusetts
  • 2Dotter Interventional Institute, Oregon Health and Science University, Portland
JAMA Cardiol. 2017;2(1):5-6. doi:10.1001/jamacardio.2016.3882

Is there enough evidence to support the use of inferior vena cava filters?—Yes.

There is a strong effort among many physicians to avoid the use of inferior vena cava filters (IVCFs) in the treatment of patients with acute deep vein thrombosis and pulmonary embolus (PE). There is no doubt that IVCF use in the United States has been skyrocketing until recently.1 There is also no debate that this increased use has been associated with observations and reports of IVCF-related complications.2 The devices have become the very public subjects of hundreds of lawsuits against manufacturers, who are likely questioning the business rationale for continuing to sell IVCFs. Admittedly, there are only sparse data regarding the survival benefit of IVCF use,3 and professional guidelines have remained consensus-based and divergent along specialty lines.4,5 This has led to sweeping condemnations and even skepticism regarding their efficacy.6