[Skip to Content]
[Skip to Content Landing]
Views 155
Citations 0
Comment & Response
April 2018

Evidence-Based Rationale for Use of Inferior Vena Cava Filters—Reply

Author Affiliations
  • 1Department of Medicine, University of California San Francisco Medicine, San Francisco
  • 2Editor, JAMA Internal Medicine
JAMA Intern Med. 2018;178(4):574. doi:10.1001/jamainternmed.2018.0061

In Reply Dr Hoffer cites the 2005 PREPIC study1 results to support a benefit in inferior vena cava (IVC) filter placement. He specifically notes “…a 50% decrease in PE risk after IVC filter placement.” Concerns have been raised that this decrease may be exaggerated because symptoms were solicited by study physicians, and patients who were symptomatic were sent for radiologic screening.2 Regardless, this same trial1 showed that the decrease in symptomatic PE came at the cost of increased recurrent deep vein thrombosis and no effect on mortality. Furthermore, the more recent randomized trial of IVC filters, PREPIC II,3 published in 2015, showed a numerically higher rate of recurrent PE in the IVC filter group and again no benefit on mortality for IVC filters.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Limit 140 characters
Limit 3600 characters or approximately 600 words