According to a recent report in MedPage Today, clinicians advise that placing inferior vena cava (IVC) filters without scheduling plans for removal is likely responsible for the increasing number of IVC thrombosis cases.
The inferior vena cava is the largest vein in the body, and an IVC filter is a cage-like device implanted in that vein. Its purpose is to catch blood clots, preventing them from reaching the heart or lungs, particularly in patients that cannot take anticoagulation medication.
Retrievable IVC models are meant to be temporary, and the FDA recommends retrieval between 29 and 54 days after insertion. However, the retrievable IVC filters have a tendency to fracture, tilt, perforate the vena cava wall and other organs, and migrate.
IVC thrombosis is at fault for an estimated 2.6 to 4.0 percent of deep venous thrombosis cases. According to Mohamad Alkhouli, MD, of the University of Rochester Medical Center in New York, and his fellow researchers, “the true incidence of IVC thrombosis may be underestimated due to the lack of standardized methods of its detection and reporting, as well as the exponential increase in the number of unretrieved IVC filters in the U.S.”
Dr. Alkhouli’s team advised that “if untreated, patients with IVC thrombosis will also suffer from significant morbidities: post-thrombotic syndrome in up to 90 percent, disabling venous claudication in 45 percent, pulmonary embolism in 30 percent, and venous ulceration in 15 percent.” They added, “Given the significant morbidity associated with IVC filter thrombosis, removal of these filters as soon as possible should be planned at the outset.”
Michael R. Jaff, DO, of Massachusetts General Hospital in Boston, agrees wholeheartedly. “Since IVC filter thrombosis is the main etiology for IVC thrombosis, think once more before placing the filter — does the patient really need it? If so, pull it out as soon as is safe and reasonable.”