CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

March 6th, 2014

Vena Cava Filters Reduce Pulmonary Emboli But Increase VTE Recurrence Tenfold

Inferior vena cava filters seem to offer protection against death from pulmonary embolism when compared with anticoagulant therapy, but they have no significant effect on all-cause mortality. In addition, the filters are associated with higher rates of recurrent venous thromboembolism, according to an article in the Journal of the American College of Cardiology.

Researchers examined data from some 40,000 patients with VTE, 344 of whom received filters because of their increased risks for bleeding (they could also receive anticoagulants). The filter recipients were matched with 344 controls on anticoagulants only.

By 30 days, the all-cause mortality rate (the primary endpoint) did not differ between the groups. A secondary endpoint, death from pulmonary embolism, favored the filter group over the controls (1.7% vs. 4.9%). However, the rate of recurrent VTE was tenfold higher among filter recipients (6.1% vs. 0.6%).

An editorialist writes that the finding on pulmonary embolism deaths “suggests that filters offer clinical benefits that are discrete from those conferred by anticoagulation.”

Categories: Prevention, Vascular
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One Response to “Vena Cava Filters Reduce Pulmonary Emboli But Increase VTE Recurrence Tenfold”

  1. Nicolas Schlapobersky, Mbbch, fcp says:
    March 7, 2014 at 12:57 am

    We use retrievable filters. We place them, and then when the patient is stable and improved, upto 3 weeks later, we simply retrieve them. That way we get the proven benefit of them, in the right situation, without any of the longterm complications. We have placed quite a number of these in the last year, and have been able to retrieve them all successfully, and without complication? Does anyone else have experience with retrievable filters?