Evidence-Based Rationale for Use of Inferior Vena Cava Filters

To the Editor Inferior vena cava (IVC) filters are used to prevent deep vein thromboses from becoming pulmonary emboli (PE). In an Editor’s Note in a recent issue of JAMA Internal Medicine, Dr Redberg argues that the absence of evidence of benefit and the definite harms of IVC filters warrants a moratorium on their use.¹ This is a step away from evidence-based medicine. Admittedly, there is limited evidence of benefit, but what evidence exists is scientifically sound; the PREPIC prospective randomized study² 8-year data clearly showed a 50% decrease in PE risk after IVC filter placement. On the other hand, there are no large IVC filter studies that support the claim of an increase in clinically significant negative outcomes.