Inferior vena cava filters: Concept review and summary of current guidelines

Luca Visconti; Alessandro Celi; Laura Carrozzi; Camilla Tinelli; Laura Crocetti; Francesco Daviddi; Raffaele De Caterina; Rosalinda Madonna; Roberta Pancani

doi:10.1016/j.vph.2024.107375

Inferior vena cava filters: Concept review and summary of current guidelines

Vascul Pharmacol. 2024 Apr 24:155:107375. doi: 10.1016/j.vph.2024.107375. Online ahead of print.

Authors

Luca Visconti¹, Alessandro Celi², Laura Carrozzi³, Camilla Tinelli⁴, Laura Crocetti⁵, Francesco Daviddi⁵, Raffaele De Caterina⁶, Rosalinda Madonna⁶, Roberta Pancani⁷

Affiliations

¹ Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa and Pulmonary Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Pulmonary Unit, Ospedale "Sacro Cuore di Gesù" Gallipoli, Azienda Sanitaria Locale Lecce, Italy.
² Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa and Pulmonary Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Pulmonary Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. Electronic address: alessandro.celi@unipi.it.
³ Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa and Pulmonary Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Pulmonary Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
⁴ Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa and Pulmonary Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
⁵ Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa and Interventional Radiology Unit, University of Pisa, Pisa, Italy.
⁶ Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa and Cardiology Unit, Cardio-Thoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
⁷ Pulmonary Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

PMID: 38663572
DOI: 10.1016/j.vph.2024.107375

Abstract

Anticoagulation is the first-line approach in the prevention and treatment of pulmonary embolism. In some instances, however, anticoagulation fails, or cannot be administered due to a high risk of bleeding. Inferior vena cava filters are metal alloy devices that mechanically trap emboli from the deep leg veins halting their transit to the pulmonary circulation, thus providing a mechanical alternative to anticoagulation in such conditions. The Greenfield filter was developed in 1973 and was later perfected to a model that could be inserted percutaneously. Since then, this model has been the reference standard. The current class I indication for this device includes absolute contraindication to anticoagulants in the presence of acute thromboembolism and recurrent thromboembolism despite adequate therapy. Additional indications have been more recently proposed, due to the development of removable filters and of progressively less invasive techniques. Although the use of inferior vena cava filters has solid theoretical advantages, clinical efficacy and adverse event profile are still unclear. This review analyzes the most important studies related to such devices, open issues, and current guideline recommendations.

Keywords: Anticoagulants; Inferior vena cava filters; Interventional radiology; Pulmonary embolism.

Publication types

Review