Table 1

Results of studies on outcomes of use of permanent IVC filters

STUDY TYPE OF STUDY TYPE OF FILTER NO. AND TYPE OF PATIENTS FOLLOW-UP TIME FINDINGS COMPLICATIONS
Wojcik et al, 6 2000 Uncontrolled retrospective review with prospective follow-up callback, case series Various permanent filters (Greenfield, bird’s nest, Simon- Nitonol) 105 patients: indications were DVT or PE or prophylaxis Mean 28.9 mo (range 5–62) No PE detected 1 filter migration (0.95%), 1 IVC occlusion (0.95%), 28 new DVTs (44%), 11 with leg swelling (10.4%)
Rousseau et al, 7 2001 Uncontrolled prospective multicentre case series 6-F nitinol TrapEase permanent filter 65 patients: indications were DVT or free-floating thrombi with contraindication to anticoagulation therapy or complications developing from anticoagulation therapy 6 mo 95.4% technical success (3 wrongly inserted filters); no symptomatic PE after 6 mo 3 filter misplacements (4.6%), 23 deaths by 6 mo (35.4%); in 42 surviving patients, 2 filter thrombosis (4.8%) but no other complications (migration, filter fracture, vessel wall perforation)
Benevenia et al, 8 2004 Retrospective review, comparative study of filters and mechanical DVT prophylaxis vs mechanical prophylaxis only Various permanent filters 47 patients, all of whom had metastatic pathologic fractures in their lower extremities and for whom anticoagulation therapy was contraindicated; prophylactic treatment (24 received filters; 23 did not) 5 y Filter group: 2 DVTs (8.3%), no PE. No filter group: 1 DVT (4.2%), 5 PE (22%) of which 2 were fatal 1 implantation revision (4.2%), 1 IVC occlusion and lower limb edema (4.2%), 1 femoral vein DVT at insertion site (4.2%), 1 insertion site hematoma (4.2%), 2 DVT (8.3%)
Zerati et al, 9 2005 Uncontrolled retrospective review Various permanent filters (LGM-VenaTech, Greenfield, TrapEase) 50 cancer patients with contraindications to full anticoagulation treatment 5 y 1 PE despite filter (2%) 20 deaths due to cancer progression (40%); of 30 survivors, 1 PE (3.3%), 2 IVC occlusions (6.7%), 1 filter thrombus (3.3%)
PREPIC study group, 10 2005 Randomized trial Permanent filters (VenTech, titanium GF, Cardinal, bird’s nest) 400 patients: indications were DVT with or without PE, randomized to receive filter or not in addition to anticoagulation therapy for at least 3 mo 8 y Symptomatic PE in 9 patients with filters (6.2%) and 24 patients without filters (15.1%); DVT in 57 with filters (35.7%) and 41 without filters (27.5%), post-thrombotic syndrome in 109 (70.3%) with filters and 107 (69.7%) without filters At 8 years, 103 patients with filters had died (2 from PE), and 98 without filters had died (5 from PE); conclusion is that IVC filters reduce risk of PE but increase risk of DVT and have no effect on overall survival or major bleeding events
Dovrish et al, 11 2006 Retrospective review, case series Greenfield permanent filter 109 patients: indications were thromboembolism despite anticoagulation therapy, contraindication to anticoagulation therapy, prophylaxis, noncompliance with anticoagulation therapy Median of 2 y 5 fatal PE despite filter (4.6%) 56 patients died, 4 patients with groin hematoma at insertion (3.5%), 1 localized infection at access site (0.9%); anticoagulation therapy as soon as possible following filter implantation resulted in 2.5-fold reduction in overall mortality and thromboembolic events
  • DVT—deep vein thrombosis, IVC—inferior vena cava, PE—pulmonary embolism.