Update on vena cava filters

Inferior vena cava (IVC) filter placement has increased dramatically over the past two decades. Filters are indicated to prevent pulmonary embolism in patients with venous thromboembolism (VTE) and a contraindication to anticoagulation or a complication of anticoagulation. Some of this increased use is the result of expanding relative indications for filter placement, including placement for primary prophylaxis. The US Food and Drug Administration has approved 11 filters for permanent deployment, two of which—the Gunther-Tulip (Cook Medical, Bloomington, IN) and the OptEase (Cordis Endovascular, Miami Lakes, FL)—are optionally retrievable. Once anticoagulation is deemed safe, all patients should be fully anticoagulated to prevent propagation and recurrent thromboembolism. Complications related to IVC filters include procedure-related issues, device complications, and secondary VTE. Therefore, the decision regarding filter placement and/or retrieval must be individualized.