Dr. Behnood Bikdeli, an internal medicine resident at Yale School of Medicine, led a team of researchers and their colleagues in a new study, which found that inferior vena cava (IVC) filters may not be the best choice in preventing pulmonary embolism.
Studying 550,000 patients who were 65 years old and older, Bikdeli discovered that IVC filters are utilized at varied rates across the different regions of the U.S. The team’s findings were published in the Journal of the American College of Cardiology, and have helped shed light on when it may or may not be necessary to use the medical device.
The best use of IVC filters is still up in the air, as different doctors have different opinions about which patients should have them and which should use anticoagulation medication instead. Very few clinical trials have been performed to study IVC filter use.
The high failure rates of some retrievable IVC filter models, such as the Recovery, G2 and G2 Express by C.R. Bard, and the Gunther Tulip and Celect models manufactured by Cook Medical, indicate that more clinical trials are desperately needed.
Dr. Bikdeli reports that he was bothered when he found that IVC filter procedures have “very narrow indications,” yet they are used in nearly one in six patients.
“Contrary to some common beliefs, they are simply not a bulletproof vest against pulmonary embolism,” Dr. Bikdeli reported. “Given that this procedure is not devoid of costs or complications, we really need good comparative effectiveness studies to determine which patients may benefit from IVC filters.”
Retrievable IVC filter manufacturers such as Bard and Cook currently face a number of lawsuits alleging injuries and death linked to filters that have migrated, fractured or tilted inside the body after they have been inserted.