Table 2. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) table showing articles on Inferior Vena Cava Filter AND complications.
IVC: Inferior Vena Cava, IVCF: Inferior Vena Cava Filter, PE: Pulmonary Embolism, VTE: Venous Thromboembolism, DVT: Deep Vein Thrombosis, CT: Computerized Tomography, PTS: Post-Thrombotic Syndrome, PTE: Pulmonary Thromboembolism, ROC Analysis: Receiver-Operating Characteristic Analysis, VTCF: VenaTech Convertible Filter, CDT: Catheter-directed Thrombolysis, PEVI: Percutaneous Endovenous Intervention, CVC: Central Venous Catheter, IVCT: Inferior Vena Cava Thrombosis
| # | Reference | Country | Design and Study Population | Findings | Conclusions | Sub-category |
| Abtahian, Farhad et al., (2014) [83] | USA | Retrospective Review (n=666) Duration: 2 years | In cancer patients, indwelling IVCF related complications occurred in 17.7% of cases versus 19.8% in the patients without cancer (P=0.50). Patients with cancer were also less likely to have their filter retrieved (28.0% vs 42.0%, P < .001). | IVCF placement in cancer patients is not associated with a higher risk of complications, but is associated with lower rate of retrieval. | Cancer Related | |
| Ahmed, Osman et al, (2020) [98] | USA | Retrospective Review (n=2857) | In the high-risk group of patients undergoing hip or knee arthroplasty, IVC filter was found to reduce the incidence of PE (0.8% to 5.5%, P = 0.028). | IVC filters are associated with lower incidence of PE in high-risk patients undergoing hip or knee arthroplasty. | Surgery related | |
| Ahmed, Osman et al, (2020) [110] | USA | Systematic review and meta-analysis (n=232) | Patients who received IVCF for massive or sub-massive PE were found to have a lower rate of mortality (6.8% vs. 26.3%) and a complication rate of 0.63% percent. | IVCF may be useful for PE prevention, but further prospectively designed studies are necessary. | Prophylactic use/Trauma | |
| Akhtar et al., (2018) [60] | USA | Retrospective study (n=7119) | National Inpatient Sample database identified patients with or without IVCF placement in adjunct to catheter-directed thrombolysis for proximal lower extremity or caval DVT. No significant difference in in-hospital mortality. Patients with IVCF placement had a significantly higher rate of hematoma (3.4% vs 2.1%, P=0.009) but higher in-hospital costs (P<0.001) and duration of admission. | In patients treated for lower extremity or caval DVT by catheter directed thrombolysis, adjunctive IVC filter placement does not significantly improve mortality outcomes while increasing patient burden of increased hospital stay and associated costs. | Treatments and Outcomes | |
| Avgerinos, Efthymios et al, (2014) [112] | USA | Retrospective chart review (n=80) | Patients undergoing thrombolysis for acute iliofemoral DVT were treated with and without adjunctive IVCF and the results were compared. No PE was found in either group, and no statistical difference in complication rate was found between groups. | IVCF should be used selectively during thrombolysis in patients with multiple risk factors, including patients with preoperative PE, women, or multiple risk factors for DVT. | Prophylactic Use/Trauma | |
| Babu, Suresh et al., (2013) [81] | UK | Retrospective cohort study (n=38) Duration: 2 years | In patients with gynecological cancer undergoing surgery, prophylactic IVCF placement resulted in no clinical complications, incidences of PE, or mortality at 6-month follow-up. | The authors conclude that IVCF placement is a safe method for prophylaxis in the prevention of PE for patients with gynecological cancer on chemotherapy who are undergoing surgery. | Cancer related | |
| Baheti, Aparna et al, (2019) [24] | USA | Retrospective chart review (n=51) | Analysis of Suprarenal IVCF placement and complications showing no incidence of indwelling filter fracture. Also, no significant change in craniocaudal position, lateral tilt, or renal function between placement and retrieval (p < 0.05) | Suprarenal IVCF placement is associated with a low complication rate and can be used safely. | Methods of Filter Placement | |
| Balabhadra, Samyuktha et al., (2020) [80] | USA | Population-based cohort (n=88585) Duration: 9 years | In cancer patients with acute lower extremity DVT, 5.1% of patients in whom IVCF was placed experienced subsequent PE, with improvement in PE-free survival in the IVCF versus the non-filter group (hazard ratio, 0.69; 95% CI, 0.64-0.75; P < .001). | For cancer patients with DVT and bleeding bleeding risk factors, IVCF placement can improve PE-free survival rate. | Cancer Related | |
| Barginear, Myra F et al., (2009) [87] | USA | Retrospective cohort study, (n=206) Duration: 2 years | Cancer patients at risk for VTE were treated with anticoagulants (AC) only (n=68), IVC filter only (n=97), and a combination (n=36). Median overall survival was 13 months with AC only, 2 months with IVC filter only, and 3.25 months with both (P<0.0002). | Anticoagulant therapy is associated with better survival outcomes than patients with contraindications requiring IVC filter. Randomized trials are needed to determine whether the poor outcomes of patients receiving IVC filters are due to a worse prognosis. | Cancer Related | |
| Berber, Onur et al, (2017) [101] | UK | Retrospective study (n=1138) Duration: 6 years | The IVCF placement rate was below the indication proposed by the EAST guidelines of practice. Retrievable IVCF were placed in 4.6% of cases, while EAST guidelines suggested filter insertion in 24.6% of cases (kappa concordance value of 0.103). | The authors concluded that the EAST guidelines may be overestimating the need for IVCF insertion, referencing the difference between PE with and without IVCF insertion of 2.2% to 1.8%, respectively. | Prophylaxis and Trauma | |
| Bikdeli, Behnood et al., (2017) [109] | USA | Systematic review & meta-analysis (n=4,204) | 11 studies met inclusion criteria (6 RCTs and 5 prospective studies). Patients with IVC filters were at lower risk for PE (OR: 0.50), increased risk for DVT (OR:1.70), lower PE mortality (OR:51), and no difference in mortality (OR:91). | There are few prospective studies to assess the safety and efficacy of IVC filters. The filters seem to lower the risk for subsequent PE, increase risk for DVT, and have no significant effect on mortality. | Prophylactic/Trauma | |
| Bistervels, Ingrid M. (2021) [130] | Amsterdam | Retrospective Cohort (n=7, additional 13 from literature review) Duration: 20 years | Retrospectively evaluated the complications of becoming pregnant with IVCF in situ, noting a complication rate of 5%. | Becoming pregnant with IVCF in place appears to be a low risk provided the filter is intact without signs of perforation. Imaging studies should be performed to confirm the filter is asymptomatic. However, the authors note that there are a limited number of cases and broad conclusions should be avoided. | Long-term Indwelling and Complications | |
| Brunson, Ann et al., (2017) [86] | USA | Retrospective population-based study (n=14000) Duration: 4 years | In patients with cancer hospitalized for VTE,, IVFC provided no reduction in 30-day mortality (HR = 1.12, 95% CI: 0.99–1.26, p = 0.08) or 180-day risk of subsequent PE (HR = 0.81, 95% CI: 0.52–1.27, p = 0.36).. Filter use showed an increased risk of subsequent DVT in these patients (HR = 2.10, 95% CI: 1.53–2.89, p b 0.0001). | IVCF provided no benefit regarding short-term mortality or subsequent PE prevention. Moreover, IVCF placement increased risk of recurrent DVT. | Cancer Related | |
| Choi, Sun-ju et al., (2018) [21] | USA | Retrospective observational study (n=78) | Femoral vs transjugular venous approaches for placement of Denali IVC filters were compared using post-placement and pre-retrieval CT imaging. Mean fluoroscopy duration was greater in the jugular approach vs right/left femoral access (64 +/- 21s vs 67 +/-15s, p<0.05. No significant difference in measured filter tilt and filter tip abutment. | Denali IVC filters can be safely placed by either transjugular or right or left femoral access approaches. | Methods of Filter Placement | |
| Chow, et al., (2015) [124] | Hong Kong | Retrospective study (n=109) | Permanent IVC filters placed in patients with previous history of VTE (DVT, PE, or IVC thrombosis). Variable duration of follow-up averaging 36 months. 29.3% developed new or recurrent VTE within 2 months of filter placement. 44.6% experienced Post-Thrombotic Syndrome (PTS). Any anticoagulation therapy improved survival rate (P=0.0002) | IVC filter placement may lower risk of PE in patients with documented history of VTE. However, further studies are needed to assess risk that long term complications may arise with permanent filters. | Long-term indwelling and complications | |
| Chua, Abigail et al., (2020) [133] | USA | Retrospective cohort (n=4053 without IVCF, n=635 with IVCF) Duration: 3 years | There was no difference in the risk for subsequent bloodstream infection following diagnosis of VTE between the IVCF group and the non-filter group (10.7% vs 8.8%; P = .12). | In patients with newly diagnosed VTE, there is no association between the IVCF placement and risk of subsequent bloodstream infection. | Long-term Indwelling and Complications | |
| Clements, Warren et al., (2022) [41] | Australia | Retrospective cohort (n=124) Duration: 3 years | In a comparison of IVCF with and without complications, neither group experienced IVC thrombosis. Breakthrough PE occurred in 1.6% of cases without anticoagulation and 3.5% with anticoagulation (1 case in each group). | Use of prophylactic anticoagulation during IVCF indwelling should not be strictly guided by the presence of a filter, but by the presence of a confluence of thrombotic risks. | Treatment and Outcome | |
| Curtis, et al., (2020) [100] | Canada | Randomized controlled trial (n=42) | High risk trauma patients who had retrievable IVCFs placed demonstrated a clinically meaningful reduction (>24 hrs) in time vulnerable to development of PE (p=0.0001). | In high risk trauma patients unable to receive pharmacologic anticoagulant prophylaxis, retrievable IVC filters may provide a limited but clinically meaningful duration of protection against PE. | Prophylactic/Trauma | |
| Dake et al., (2019) [9] | USA | Prospective study (n=129) | Evaluation of the short term prophylactic utility of bio convertible Sentry IVC filter in patients with or without history of DVT and/or PE. Within the 2-year course of the study, 2.4% developed new PE, 1.6% developed IVC thrombosis. 17 new or worsening DVTs were deemed to be non-filter related. | The Sentry IVC filter may lower risk of PE for high risk patients but this is limited to a 60 day period prior to designed filter bioconversion. | Comparison of Filter Types | |
| Desai, et al., (2014) [121] | USA | Retrospective Study (n=1234) | This study sought to compare long term complications associated with indwelling permanent vs retrievable IVC filters. Thrombotic complications were most frequent in both permanent and retrievable (4.4% & 2.2%, P=NS). Patients with retrievable filters were younger (mean age 62 vs 74, P<0.0001), had an overall higher complication rate (9% vs 3%), P=<0.001) and significantly higher number of device related complications (3% vs 0.5%, P=0.0035). | Retrievable IVC filters tend to be placed in a younger population and have a higher rate of long-term complications than permanent filters. Care should be taken to avoid long term placement of retrievable filters. | Long-term indwelling and Complications | |
| Dewdney, et al., (2011) [82] | USA | Retrospective study (n=103) | Indications for IVC filter placement and survival rates were analyzed In patients with confirmed gynecologic cancer. Indications were: contraindicated to anticoagulation due to hemorrhage (44%), perioperative indication (30%) and following attempted then failed anticoagulation (14%). Survival rates were not significantly different based on indication (P=0.18). Improved survival was associated with anticoagulation treatment following IVCF placement (HR 0.45, 95% CI 0.45-0.27, P=0.003). | In patients with gynecologic cancer, IVC filter placement does not significantly improve survival. Patients who are able to receive anticoagulation after IVCF placement may have marginally improved survival than those unable to receive anticoagulation but may be impacted by lower prognosis for contraindications to anticoagulation due to worsening or complicated disease. | Cancer related | |
| Duffett et al., (2014) [4] | Canada | Retrospective study (n=338) | Filter related complications in 20% of the population studied. One or more thrombotic complications occurred in 11% even after initiating anticoagulation following filter placement; filter thrombosis (7%), new or progressed PE or DVT (3% and 5%, respectively), or insertion complication due to thrombosis (1%). Mechanical complications also reported; incomplete deployment (1%), IVC wall penetration/injury (1%), filter fracture (0.6%), migration (0.3%). | Because of high thrombosis associated complications, further studies are needed to evaluate safety and effectiveness of IVC filters, as well as the appropriate timing of anticoagulation therapy following IVC filter placement. | Treatment and Outcome | |
| Elkbuli, Adel et al., (2020) [104] | USA | Retrospective review (n=513) Duration: 6 years | This study examined whether the timing of IVCF placement affected outcomes, reporting no change in significant differences in DVT, PE, or in-hospital mortality(P > .05 for all), but a shorter ICU and hospital length of stay if the filter was placed within the first 48 hours. | IVCF placement within the first 48 hours is associated with shorter ICU and hospital length of stays. | Prophylactic/Trauma | |
| Falatko et al., (2016) [129] | USA | Retrospective cohort study (n=152) | In a population of patients who had IVC filters placed at age 60+ for recurrent PE, there is no significant difference in incidence of mortality when comparing those who received anticoagulation therapy post filter placement vs who had not due to contraindication of anticoagulation (P=0.46). HR for age was 1.03 (CI1.00-1.06; p-value <0.0001) and HR for BMI was 0.92 (CI 0.89-0.97; p-value 0.002). | In patients with advanced age, the benefit of anticoagulation therapy after IVC placement may be reduced than for a younger population. Advanced age may provide a prognostic factor and BMI may provide a protective factor. | Long term indwelling and complications | |
| Ganguli, Suvranu et al., (2016) [17] | USA | Retrospective observational study (n=688) Duration: 3 years | Bedside placement generally occurred on younger patients who less often had malignancy (P < 0.001) and more commonly received prophylactic filters (P < 0.001). Placement related complications occurred in 4.3% of bedside placements and 0.6% of fluoroscopy placements. Indwelling related complications occurred more equally: DVT: P = 0.92 PE: P = 0.61 Filter Thrombosis: P = 0.82 Timing for complications was also similar (74 vs 120 days P = 0.29) | Bedside placement guided by ultrasound can be deemed safe but is associated with more placement complications compared to fluoroscopy. Both placement methods result in similar long term complications. | Methods of Filter Placement | |
| Gargiulo III, Nicholas J. et al., (2010) [97] | USA | Retrospective study (n=58) Duration: 8 years | In patients undergoing gastric bypass surgery in whom IVCF placement occurred, 3.4% (2/58) developed DVT. | The authors conclude that IVCF placement is a relatively benign, safe intervention which can be largely beneficial in the prevention of DVT in patients undergoing gastric bypass. Filter placement can be particularly beneficial in the obese population. | Surgery Related | |
| Giorgi, Marcoandrea et al., (2018) [95] | USA | Retrospective chart review (n=49) Duration: 7 years | In patients undergoing bariatric surgery, one patient in whom IVCF was placed developed DVT and PE. 98% of filters were removed without complication. | Retrievable IVCF can be placed safely and effectively as prophylaxis against venous thromboembolism in patients undergoing bariatric surgery. | Surgery Related | |
| Given et al., (2008) [68] | Australia | Retrospective review (n=317) Duration: 4 years | 322 GT filters were placed in 317 patients. Retrieval was attempted in 205 patients, with 15 failures giving 92% success rate. Average indwelling time was 76.95 days. 19 filters were placed permanently. 3 minor complications occurred with insertion, 5 complications with retrieval. | Insertion of Gunther Tulip filters is a safe procedure. Reported retrieval times have extended beyond the recommended 14 days which may negatively affect successful retrieval rates. | Filter Types | |
| Goldman, Daryl T. et al., (2019) [91] | USA | Retrospective study (n=7258) Duration: 4 years | Inclusive of all BMI indices, IVCF complication rate was 2.6%. Increased BMI was associated with increased rate of filter angulation (P = .03). | Increased BMI is associated with increased rate of filter angulation, but was not indicative of other filter-related complications. | Surgery Related | |
| Grullon, Jenies et al., (2022) [22] | USA | Retrospective study (n=13221) Duration: 6 years | IVCF angulation occurred more frequently in filters placed via the femoral access point compared to jugular access (0.9% vs 0.34%; OR 1.46 CI 1.02-15 2.11; p=0.04). | Transjugular placement of IVCF has a lower risk of filter angulation and access site complications compared to transfemoral insertion. | Methods of Placement | |
| Gul, Muhammad H. et al., (2019) [50] | USA | Retrospective observational study (n=254,465) Duration: 12 years | In patients with PE with complicating cardiac issues, mortality rate was lower in the group receiving IVCF versus those without (20.9% vs. 33%; NNT = 8.28, 95% confidence interval (CI) 7.91–8.69, E-value = 2.53). | In patients with PE and acute myocardial infarction, acute respiratory failure, shock, or requiring thrombolytic therapy, IVCF insertion was associated with lower mortality rate. | Treatment and Outcomes | |
| Hammond, C.J. et al., (2009) [38] | UK | Retrospective study (n=516) Duration: 12 years | IVCF placement complication rate was 0.4% over this time period. Retrieval complication rate was 1%. 24-hour and 30 day mortality rates were 1% and 8%, respectively. | IVCF placement and retrieval are associated with a limited rate of complications, but there is often a lack of follow-up in these cases resulting in a dearth of insight into efficacy and safety. | Treatment and Outcomes | |
| Han, Kichang et al., (2021) [77] | Korea | Prospective RCT (n=136) Duration: 2 years | The authors compared Denali and Celect IVCF, finding that the Celect group had a higher rate of filter tile >15° and strut penetration (P = 0.033 and 0.001, respectively). | Denali filters have a lower rate of filter tilt >15° and strut penetration when compared to Celect filters. | Comparison of Filters | |
| Haskins et al., (2018) [93] | USA | Retrospective study (n=286,704, 2512 in whom IVCF was placed) | High VTE risk bariatric surgery patients who had IVC filters in place at the time of surgery did not have a statistically significant lower incidence of postoperative PE compared with a matched subgroup. | In patients undergoing bariatric surgery, prophylactic placement of IVC filters for patients deemed high risk may not have the intended protective effect against development of clinically significant PE. | Surgery related | |
| Haut, Elliott R et al., (2013) [108] | USA | Review and meta-analysis (n=1064) | Relative risk was 0.20 for PE in patients with IVC filter versus patients without (P=0.01). | Prophylactic IVC filter placement is associated with lower risk of PE and acute PE in trauma patients. | Prophylaxis/Trauma | |
| Ho, K.M. et al., (2014) [103] | Australia | Retrospective cohort study (n=2940) Duration: 5 years | IVCF in trauma patients was examined with 16% developing DVT or VTE following placement of the filter. Mechanical complications, including adherence to the IVC wall (4.9%), IVC thrombus (4.0%), and displaced or tilted filters (2.2%) became more prevalent with indwelling time longer than 50 days. | Longer indwelling time or delay in pharmacological prophylaxis increased the risk of IVCF related mechanical complications in patients who had experienced major trauma. | Prophylactic Use/Trauma | |
| Ho, Kwok M. et al., (2022) [128] | Australia | Prospective study (n=100) | There was a positive correlation between length of indwelling time and loss of metallic elasticity of the filter struts (Pearson correlation coefficient, 0.232; P =.008). | Prospective analysis suggests that metallic fatigue contributes to IVCF strut fractures. There is a correlation between the length of indwelling time and metallic fatigue. | Long-term Indwelling | |
| Huang, Junjie et al., (2021) [99] | China | Retrospective study (n=964) Duration: 3 years | In patients with fractures and DVT in whom IVCF was placed, there were no incidences of subsequent PE. Patients were divided into above-knee DVT, popliteal vein thrombosis, and below-knee DVT, with no significant difference in filter thrombosis between groups (11.04%, 11.70%, and 8.06%, respectively). | In patients with fractures and DVT awaiting orthopedic surgery, IVCF placement can prevent PE. | Surgery Related | |
| Isogai, Toshiaki et al., (2015) [55] | Japan | Retrospective study (n=13125) | The authors examined the effectiveness of IVCF as an adjuvant to antithrombotic therapy, reporting a lower in-hospital mortality versus the no-filter group (2.6% vs 4.7%, P < .001; risk ratio 0.55; 95% confidence interval [CI], 0.43- 0.71; risk difference 2.1%; 95% CI, 3.0% to 1.2%; number needed to treat, 48; 95% CI, 34-82). | IVCF use may decrease the rate of in-hospital mortality in patients with PE. The authors note a need for further prospective study. | Treatments and Outcomes | |
| Iwamoto, Yumiko et al., (2014) [125] | Japan | Retrospective cohort study (n=72) Duration: 9 years | For patients with DVT in whom permanent IVC filters were placed, there were no new symptomatic incidences of recurrent PE at 1-month follow-up. | Underlying thrombotic conditions and diseases seem to play a large role in determining the prognosis for patients with DVT, regardless of IVCF placement status. IVCF in combination with anticoagulation may reduce risk of death due to recurrent PE in patients with DVT. | Long-term indwelling and complications | |
| Jaberi et al., (2019) [43] | Canada | Retrospective study (n=36) | Authors identified patients with indwelling retrievable filters for follow-up and to review possibility of removal. CT imaging found asymptomatic complications; IVC occlusion (5.8%), filter fracture (11.7%), and penetration grades 2-3 (93.75%). | Retrievable IVC filters should be removed when no longer indicated in order to prevent risk of long-term complications associated with chronic IVC filters. | Long-term indwelling and complications | |
| Jha, V. M. et al., (2010) [53] | USA | Retrospective study (n=248) Duration: 2.75 years | Study’s population inclusive of patients admitted for acute PE and resultant in full anticoagulation therapy. Data analyzed include whether there is right heart strain, DVT, and IVC placement. 13.3% had IVC placement. IVC placement was significantly more likely in documented DVT or IVC (P<0.0001 DVT, P<0.001 in right heart strain). But whether or not IVC reduced mortality (hospitalized) was not statistically significant. | For patients with acute PE, IVC filter in adjunct to full anticoagulation therapy was more likely in patients with right heart strain or DVT. Further studies need to investigate whether the placement of IVF filters in hospitalized patients with acute PE and pre-existing diagnoses of right heart strain or DVT actually reduces mortality risk. | Treatment and Outcomes | |
| Jiang, Jianguang et al., (2016) [59] | China | Retrospective study (n=189) Duration: 9 years | In patients undergoing catheter-directed thrombolysis in whom IVCF was placed, there were no major thrombolytic or placement complications, and no incidence of symptomatic PE. 4.2% of patients were found to have IVCF thrombus during the catheter-directed thrombolysis procedure. | IVCF thrombus during catheter-directed thrombolysis is uncommon, and patients in whom this occurred did not require additional treatment. | Treatment and Outcomes | |
| Johnson, Matthew S et al., (2010) [72] | USA | Prospective multicenter clinical study (n=100) | Retrievable Option IVC filter placement resulted in 100% technical success (deployment of filter with suitable mechanical protection from PE) and 88% clinical success (technical success without recurrent PE or other complications). | The Retrievable Option IVC filter can be placed in patients at risk for PE with few complications and significant reduction in subsequent PE. | Filter Types | |
| Joseph and Lopera, (2021) [18] | USA | Retrospective study (n=9) | Bedside guided placement of IVC filters via portable digital radiography (DR), in ICU patients with high ICP and raised head of bed for prophylaxis (n=8) and acute DVT (n=1). One post-procedural complication was 23% filter tilt. | IVC filters can be placed safely at bedside in patients who are unable to lay supine due to high ICP following head trauma. | Methods of Filter Placement | |
| Juluru, Krishna et al., (2016) [44] | USA | Retrospective observational cohort Study (n=293) Duration: 6 months | A semi-automated filter tracking system was developed over 100 hours. Control and test groups were studied over 6 months. Filter retrieval for the control group was 23%. Retrieval in the test group was 34%. There was no significant difference between time of placement and retrieval (p = 0.32) | Semiautomated tracking systems for patients with IVC filters can help coordinate clinical approach and patient care. Effectiveness can be further augmented with applications designed to improve provider communication and management plans. | Long-Term Indwelling and Complications | |
| Kai, Ryuichi et al., (2005) [78] | Japan | Prospective cohort study (n=50) Duration: 3 years | Comparison of temporary versus permanent IVC filters in patients with PE and/or floating DVT. 18 patients were given permanent filters, 32 temporary. Mortality rate was 35% in the former group and 16% in the latter (P=0.14). PE recurrence was 18% in the permanent filter group, with no instances of recurrence in the temporary filter group (P=0.10). | Temporary IVC filters offer a safe and effective method to reduce risk of recurrent acute Pulmonary Thromboembolism (PTE). Moreover, implantation during the acute phase of PTE reduces the risk of thrombosis. Long-term studies considering the benefits of placement against long-term complications must still be done. | Filter Types | |
| Kalva, Sanjeeva P. et al., (2006) [62] | USA | Retrospective study (n=751) Duration: 4 years | Examination of the efficacy and safety of the TrapEase IVC filter in a 4-year span of a single medical center. 7.5% of patients developed symptoms of PE and 1 death was attributed to PE. | The TrapEase filter was effective at preventing pulmonary embolism. Complications and recurrent PE were found to be low. | Comparison of Filter Types | |
| Kalva, Sanjeeva, P. et al., (2006) [65] | USA | Retrospective study (n=96) Duration: 1 year | Recovery IVCF were placed in 96 patients, with 12 developing symptoms of PE, and only 1 of the 12 having PE on CT imaging. Filters were successfully removed in 82% of patients. | No incidences of PE were found in the patient group, but there were high occurrences of asymmetric deployment of filter legs, fractures of the filter, and asymptomatic caval penetration. | Comparison of Filter Types | |
| Kalva, Sanjeeva P. et al., (2010) [66] | USA | Retrospective study (n=71) Duration: 5 years | At 20-month follow-up of patients who received an OptEase IVCF, 15% had symptoms of postfilter PE and 11% had symptoms of DVT. None of the aforementioned patients had PE on CT. | OptEase filters are effective against PE and have an acceptable long-term complication rate. | Comparison of Filter Types | |
| Kaw, Roop et al., (2013) [94] | USA | Systematic review & meta-analysis (n=102767) | Search was narrowed to adult patients undergoing bariatric surgery with or without IVCFs to assess postoperative outcomes. Incidence of DVT and mortality was found at higher significance of patients with IVC filters (P = 0.007, P = 0.1 respectively). There was no significant difference in risk of PE. | Patients undergoing bariatric surgery with IVC filters in place are at a higher risk for postoperative DVT and death. Risk of PE with or without IVC filters could not exclude a benefit in this study. Randomized control trials are recommended before IVC placement. | Surgery Related | |
| Kawamata, Kazuya et al., (2005) [118] | Japan | Retrospective study (n=11) Duration: 6 years | Temporary IVC filters were placed prophylactically in pregnant women with DVTl, with the authors reporting no incidences of placement or retrieval complications, nor occurrence of subsequent pulmonary thromboembolism. | IVCF may reduce risk for pulmonary thromboembolism in pregnant patients with DVT. | Prophylaxis/Trauma | |
| Kazmers, Andris et al., (2002) [73] | USA | Retrospective study (n=151) | Greenfield IVC filters were placed in 151 patients (152 cases) with an overall 30-day mortality rate of 30 days. Mean survival rate after filter placement was 4.96 years. | Greenfield filters can be placed safely and reduce the incidence of recurrent PE in patients with contraindications to anticoagulant therapy. | Comparison of Filter Types | |
| Kim, Hyoung Ook et al., (2016) [23] | Korea | Retrospective study (n=21) | In patients with lower extremity DVT, both IVC filter placement (OptEase) through the popliteal vein and PEVI were performed during a single session. Six patients (28.6%) had rethrombosis found in follow-up. Filter tilt ≥15° found in 3 patients. | IVC filter insertion through the popliteal vein can be done safely with PEVI in a single session for patients with lower extremity DVT to reduce PE-risk due to PEVI. | Methods of Filter Placement | |
| King, Ryan W. et al., (2021) [37] | USA | Retrospective study (n=12,874) Duration: 6 years | The authors performed a multivariable analysis which determined the independent indicators for IVCF thrombosis as new or propagated deep vein thrombosis at follow-up ( [HR], 16.3; 95% [CI], 9.8-27.3; P<0.001), no antiplatelet therapy at follow-up (HR, 4.8; 95% CI, 1.9-12.5; P=0.001), internal jugular venous access (HR, 2.2; 95% CI, 1.4-3.5; P=0.001), the presence of VTE on admission (HR, 2.7; 95% CI, 1.4-5.1; P =0.002), and temporary IVCF placement (HR, 2.5; 95% CI, 1.1-5.6; P=0.031). | Multivariate analysis suggests that given the indicators for IVCF thrombosis, antiplatelet therapy should be considered after IVCF placement to decrease the risk of IVCF thrombosis. | Treatments and Outcomes | |
| Koizumi, Jun et al., (2018) [76] | Japan | Retrospective study (n=532) Duration: 12 years | IVCF fracture occurred in 0.7% of Gunther Tulip filters and 14.1% of TrapEase/OptEase (P<0.001). | TrapEase/OptEase filters have a high incidence of filter fracture and are not suitable for long-term/permanent insertion. | Comparison of Filter Types | |
| Kolbel, Tilo et al., (2008) [58] | Sweden | Retrospective study (n=40) Duration: 12 years | In patients undergoing catheter-directed thrombolysis in whom IVCF was placed, 45% developed visible emboli within the filter. There were no incidences of symptomatic PE or filter-related complications. | In patients undergoing catheter-directed thrombolysis, thrombus embolization is common and IVCF placement can help reduce the risk of silent and symptomatic PE. | Treatments and Outcomes | |
| Konishi, Hiromi et al., (2015) [131] | Japan | Retrospective study (n=45) Duration: 25 years | Temporary IVCF were placed in pregnant women with DVT, resulting in a complication rate of 10%. Onset of DVT occurred later in women with filter placement compared to those without (22 vs 12 weeks; P= .002). | Pregnant women with bleeding risks may be a subset in which temporary IVCF placement could be beneficial to prevent DVT. The authors report a need for a larger prospective study to examine this conclusion. | Surgery Related | |
| Laborda, Alicia et al., (2014) [132] | Spain | Prospective cohort study (n=101) | After valsalva maneuver, measured 60% increase in IVC cross sectional area and 5x increase in IVC pressure (P<0.001) | Reduction in cross sectional area is associated with higher risk of filter penetration | Long-Term Indwelling and Complications | |
| Laidlaw, Grace et al., (2021) [126] | USA | Retrospective cohort study (n=252) Duration: 4 years | Larger IVC diameter was associated with a greater filter tilt (p = 0.0004). Greater tilt and longer indwelling times were associated with more advanced retrieval techniques (p = 0.01 and p = 0.002 respectively) | Larger IVC diameter can be used to predict greater filter tilt change which leads to complications during retrieval. | Long term indwelling and Complications | |
| Lee, Brian E. et al., (2017) [71] | USA | Retrospective Review (n=562) Duration: 3 years | Celect IVCF placement resulted in one case of subsequent PE and two indeterminate cases found on follow-up CT angiography (2.6%-7.7%). | Outcomes in this study were similar to those reported for first-generation Celect filters. | Filter Types | |
| Lee, Jung-Kyu et al., (2014) [39] | Korea | Retrospective Observational Study (n=45) Duration: 9 years | Receiver-Operating Characteristic (ROC) curve analysis was used to predict IVC filter penetration based on indwelling time and 1/IVC diameter. AUC for indwelling time was 0.855 (P< 0.001) and had sensitivity of 80.8% and specificity of 78.9% to predict penetration. AUC for 1/IVC diameter was 0.647 (P<0.048). IVC diameter of 24.2 mm was estimated to have sensitivity of 73.1% and specificity of 68.4% | Penetration on CT was common for patients with a retrievable filter. Significant penetration was associated with indwelling times > 20 days and IVC diameter < 24.4 mm. | Treatment and Outcomes | |
| Lee, Sang Yub et al., (2018) [26] | Korea | Retrospective Cohort Study (n=221) Duration: 8 years | IVCF tilt angle, presence of external compression, and IVC morphology were different between filter tip abutment and non-abutment groups (P<0.05). | There was a significant difference between the filter tip abutment and non-abutment groups regarding filter tilt angle, external compression, and IVC morphology. Identifying these factors may help guide filter placement away from dangerous areas. | Long term indwelling and complications | |
| Lee, Scott J. et al., (2022) [115] | USA | Retrospective Study (n=11938) Duration: 7 years | Prophylactic IVCF placement in trauma patients was negatively associated with in-hospital mortality risk(OR: 0.46, P<0.01), but positively associated with PE (Odds Ratio (OR): 5.25, p < 0.01) and DVT (OR: 5.55, p < 0.01). | There was a positive correlation between prophylactic IVCF placement in trauma patients with PE and DVT, but a negative association with in-hospital mortality. The authors conclude that further research is needed to examine the benefits and detriments of IVCF prophylaxis in this patient group. | Prophylaxis and Trauma | |
| Lee, Seul-Hee et al., (2015) [116] | Korea | Retrospective study (n=70) | Retrievable IVC filters were implanted prior to catheter-directed thrombectomy of symptomatic lower extremity DVT with or without PE to manage procedure related embolic shedding in conjunction with oral anticoagulation and stocking therapy. 31.4% of patients had thrombus trapped by IVC filter. At the end of the study period, 75.7% remained indwelling. No patient developed new PE. | In patients with symptomatic lower extremity DVT who undergo catheter directed thrombectomy. IVC filter implantation can capture thrombus and may possibly contribute to prevention of development of PE in combination with anticoagulation and stocking usage. Further randomized studies are needed to elucidate benefits attributable to IVC filters. | Prophylactic use/Trauma | |
| Liang, Nathan L. et al., (2016) [52] | USA | Retrospective study (n=263,955) Duration: 3 years | IVCF placement in patients with acute PE did not significantly decrease the mortality risk versus untreated patients (HR 0.93, 95% CI[0.89-1.01]). | The authors report that in patients with acute PE, IVCF does not significantly improve mortality outlook after accounting for survivor treatment selection bias. | Treatments and Outcomes | |
| Lin, Lawrence et al., (2020) [11] | USA | Prospective study (n=149) | IVC thrombosis occurred in 4 out of 28 patients with non-converted VenaTech Convertible Filter (VTCF), and zero out of 76 with converted VTCF (P=0.006). | VenaTech convertible filters in the convertible configuration reduced complications and risk of thrombosis and may be useful for patients with ongoing risk of VTE. | Filter Types | |
| Lin, Peter H. et al., (2002) [16] | USA | Retrospective study (n=592) Duration: 13 years | IVCF complication rates were not significantly different when placed by interventional radiologists versus vascular surgeons (2.1% to 2.4%, P=.48). Similarly, there was no significant difference in mortality rate between placement by interventional radiologists compared to vascular surgeons (3.8% to 3.6%, P>1.0). | Both interventional radiologists and vascular surgeons are qualified to place IVCF with no significant differences in complication rate or mortality. | Methods of placement | |
| Liu, Yang et al., (2021) [54] | China | Systematic review and meta-analysis (n=1274) | IVC filter does not significantly reduce PE associated mortality within 3 months of placement or entirety of patient follow-up. IVC filter is associated with lower risk of new PE within 3 months and entirety of patient follow-up (P=0.001). | IVC filter placement may reduce new occurrences of PE without significantly reducing risk of mortality, new DVT, or major bleeding. | Treatment and Outcomes | |
| Looby, S. et al., (2006) [69] | Ireland | Retrospective study (n=147) Duration: 4 years | Gunther Tulip IVCF were placed in 147 patients with no occurrence of subsequent IVC thrombotic events. There were 4 instances of pneumothorax, 1 instance of failure of filter expansion, and 1 incident of breakthrough PE. | The authors conclude that Gunther Tulip retrievable filters can be used safely, with a mean retrieval time of 33.6 days and minimal complications. | Comparison of Filter Types | |
| Mahmood, Syed et al., (2016) [89] | USA | Retrospective cohort study (n=154) Duration: 2 years | Patients with metastatic carcinoma had an increased rate of filter complications versus patients with localized cancer (25% vs 11%, P = .03). Lower filter-related complication rates were also noted in patients able to accept anticoagulation concordantly with IVCF (odds ratio, 0.3; P = .005). | Patients with metastatic carcinoma are at increased risk of filter-related complications, and whenever possible, anticoagulation should be re-initiated to reduce the likelihood of these complications. | Cancer Related | |
| Mansour, Asem et al., (2014) [88] | Jordan | Retrospective analysis (n=107) Duration: 7 years | Patients with stage IV cancer in whom IVCF was inserted had a mean survival time of 1.3 months, with 67.8% of patients living less than 3 months. | IVCF may be used in cancer patients if anticoagulation is not an option, however, providers should consider the stage and life expectancy of the patient and the complication/benefit ratio the filter may provide. | Cancer Related | |
| McLoney, Eric D. et al., (2013) | USA | Retrospective review (n=465) Duration: 1987 days | IVCF perforation was more likely in women, (45.5%) compared with men (30.8%; P = .002), and those with pre-existing malignancy compared to those without (43.7% to 29.9%; P = .001). | In comparison of Celect, Tulip, and Greenfield IVC filters, there was no significant difference in perforation rate between Celect and Tulip, with Greenfield filters having the lowest rate of perforation. | Filter Types | |
| Mellado, Mertixell et al., (2016) [56] | Spain | Retrospective cohort study (n=59,663) Duration: 14 years | For patients with VTE recurrence presented as DVT, there was no significant difference in death for filter insertion vs no filter (17.7% vs 12.2%, p = 0.56). For patients with VTE recurrence that presented as PE, there was a significant decrease in all-cause death for filter insertion vs no filter (2.% vs 25.3%, p = 0.08) | IVC filter insertion was not associated with survival benefit for patients with recurrent DVT in the first 3 months of anticoagulant therapy. Filters were associated with a lower risk in all-cause death for patients with recurrent PE. | Treatment and Outcomes | |
| Mikhael, Bassem et al., (2019) [134] | USA | Prospective study (n=1070) Duration: 2 years | The authors tracked retrieval and complication rates using a computer reminder program in patients with who had an IVCF placed previously, noting increased retrieval rate (49.8% vs. 31.2%, p = 0.0001), and reduced indwelling complication rate (9.4% vs. 16.1%, p = 0.005), in the “reminder provided” group versus the “reminder not provided group”. | This study concludes that adding an email reminder system leads to a higher rate of IVCF retrieval and a lower indwelling complication rate. | Long-Term Indwelling and Complications | |
| Miyahara, Takuya et al., (2006) [40] | Japan | Retrospective study (n=33) Duration: 5 years | Retrievable IVCF were placed in 33 patients with mean∓ SD indwelling time of 10.6∓ 7 days. There were no cases of PE during filter protection or retraction, but major filter-related complications occurred in 27.3% of patients. | The retrievable IVCF were effective at preventing PE, however, many complications occurred during the protection period. | Treatments and Outcomes | |
| Muriel, Alfonso et al., (2014) [57] | Spain | Prospective cohort (n=40142) Duration: 30 days | In patients with acute symptomatic venous thromboembolism and a significant bleeding risk, IVCF was shown to decrease all-cause mortality compared with no-insertion (6.6% vs. 10.2%; p = 0.12). PE-related mortality was also reduced in this group (1.7% vs. 4.9%; p = 0.03). | In patients with acute symptomatic venous thromboembolism and a significant bleeding risk, IVCF is associated with lower mortality risk versus no-filter placement. However, the limitations of the study prevent declaration of a causal relationship. | Treatment and Outcomes | |
| Nazzal et al., (2010) [33] | USA | Retrospective study (n=400) | Analysis of all patients who had an IVC filter placed at a single center, with a focus on complications. Early complications (during or immediately post-operatively) were minor and associated with hematoma and ecchymosis (0.4% patients) and late complications (months to years) include IVC thrombosis (4.75%), PE (1.5%), ipsilateral limb thrombosis (3.8%) and filter migration (1.5%). IVC thrombosis incidence was significantly higher specifically for TrapEase filters compared to other filter types (25% vs 0%, P<0.05) in a subset of hypercoagulable/malignant disease. | A single institution can safely place a variety of IVC filters for different indications without procedural or immediate post-operative conditions, while achieving no significantly different outcomes. However, a specific subset of patients with hypercoagulable states or malignant disease may experience a higher rate of IVC thrombosis with a TrapEase filter. | Treatments and Outcomes | |
| Pan et al., (2016) [120] | China | Retrospective Cohort Study (n=764) Duration: 8 years | In the initial pre-retrieval venogram, 236 patients were found to have thrombus within the filter 12-39 days after placement. Complete occlusion was seen in 18 cases. Retrieval was attempted in 121 cases of small clots, 120 retrievals were successful. Larger thrombi and complete occlusions were treated with Catheter-directed Thrombolysis (CDT). Overall, 213 cases were treated for thrombus without incidence of PE | Small clots are able to be retrieved without additional management. Larger occlusions can be pre-treated with CDT to assist in retrieval. Filter retrieval with manual negative pressure aspiration thrombectomy seemed valuable for management of larger occlusions. | Prophylaxis/Trauma | |
| Ramakrishnan, Ganesh et al., (2022) [42] | USA | Retrospective study (n=14784) Duration: 7 years | Immediate and delayed filter complication rates were 1.8% and 3.1%, respectively. | Immediate and delayed filter complications were not associated with increase in mortality. IVCF complications can be minimized by prompt filter removal. | Treatments and Outcomes | |
| Rauba, Jason et al., (2022) [122] | USA | Retrospective cohort study (n=1709) Duration: 6 years | Rates of subsequent DVT (8.1% vs 11.9%; P=.05; hazard ratio, 0.65; 95% confidence interval, 0.42-1.00) and mortality (8.8% vs 28.8%; P < .001; hazard ratio, 0.5; 95% confidence interval, 0.35-0.7) were lower in patients who had IVCF removed at mean follow-up time of 36 ±16 months. There was no significant difference in rates of PE between the groups. | This study compared rates of retrieval success, subsequent DVT, mortality, and PE in patients with and without filter retrieval, reporting that longer indwelling times and failure of filter removal resulted in higher complication rates and less retrieval success. | Long-term Indwelling | |
| Reddy, Satyajit et al., (2019) [92] | USA | Observational study (n=258,480) Duration: 10 years | The authors report that in patients undergoing bariatric surgery, prophylactic IVCF placement resulted in higher risk of in-hospital mortality or PE than in patients without filter (1.4% vs. 0.4%; odds ratio: 3.75; 95% confidence interval [CI]: 1.25 to 11.30; p = 0.019). | Prophylactic placement of IVCF may not be beneficial in patients undergoing bariatric surgery, as both mortality and complication rates were higher. | Surgery Related | |
| Ribas, Jesus et al., (2020) [123] | Spain | Retrospective cohort study (n=271) Duration: 11 years | Of 271 VTE patients, 205 received a temporary IVC filter. 37 patients died during the same hospitalization period as when the filter was inserted. 111 patients later had successful retrieval of the filter. 57 patients did not have retrieval for several reasons, primarily being lack of follow-up. | Lack of follow-up is a preventable cause of long-term temporary filters in VTE patients. Structured programs should be implemented to increase retrieval rates | Long-term indwelling and Complications | |
| Rosenthal, David et al., (2004) [105] | USA | Retrospective study (n=94) Duration: 16 months | Filters were placed within 48 hours of admission for 83 patients. 91 filters were placed without complications at L2-3. 3 filters were misplaced in the right iliac vein but were retrieved and replaced with an IVCF within 24 hours. Clinical success was determined with vena cavograms. 44 filters were not removed: 41 in patients with continued contraindication to anticoagulation therapy, 3 filters with trapped thrombus. | In patients with multiple trauma, bedside IVCF placement serves as a safe, effective bridge until anticoagulation therapy can be initiated. | Prophylaxis/Trauma | |
| Rosenthal et al., (2006) [106] | USA | Clinical Trial (n=127) | Retrievable filters were placed in multitrauma patients at high risk for PE. Prior to filter retrieval, patients re-evaluated and US of lower extremities found DVT in 4 patients. Filters were also evaluated after retrieval and three filters had >25% thromboses. Four filters were not removed d/t trapped thrombus. | Temporary IVC filters placed in patients with multiple traumas may be effective PE prophylactic treatment. Though intended for temporary placement, development of thrombus within the filter may prevent removal. | Prophylaxis/Trauma | |
| Sangwaiya, Minal Jatiania et al., (2009) [70] | USA | Retrospective study (n=73) Duration: 11 months | Of the 61 patients whose filters were placed guided by fluoroscopy, 4 filters showed immediate tilt. During follow up, 2 patients had CT confirmed PE. Radiography of 47 patients showed no filter migration. Abdominal CT of 18 patients showed filter-related complications (penetration, fracture, etc.) in 7. 14 filters were successfully removed. | The Celect IVC filter can be safely deployed and retrieved but is associated with high incidence of caval filter leg penetration. | Filter Types | |
| Schuster, Rob et al., (2007) [96] | USA | Retrospective Study (n=24) Duration: 3 years | In morbidly obese patients undergoing gastric bypass surgery, IVCF placement resulted in no deaths, with 21% of patients developing post-operative PE or DVT. | Preoperative placement of IVCF is recommended in high-risk morbidly obese patients undergoing gastric bypass surgery. | Surgery Related | |
| Shabib, Abdullah Bin et al., (2018) [32] | Saudi Arabia | Retrospective study (n=382) Duration: 9 years | IVC filters were placed in 382 patients of a single medical center between 2007-2016 with thrombotic complications occurring in 72 (19%) and mechanical complications occurring in 7 (1.8%) of cases. | Complications stemming from IVC filters can be significant. Patients with acute VTE and contraindication to anticoagulation is a widely accepted indication for use of IVC filter, but for cases outside of this scope, indications for placement must be more clearly defined. | Treatment and Outcomes | |
| Shaikh, Saba S. et al., (2020) [85] | USA | Retrospective study (n=386) Duration: 4 years | The authors examined the placement of IVCF in the cancer population, noting that median time from filter placement to death was 8.9 months in the retrievable filter group, and 3.2 months in the permanent filter group. | The study concludes that indications for filter placement in the cancer population are unclear, given the short time from filter placement until death, the cost, complication rate, and risk of recurrent VTE. | Cancer Related | |
| Sharifi, et al., (2012) [61] | USA | Clinical trial (n=141) | Patients undergoing percutaneous endovenous intervention (PEVI) procedure as treatment for DVT had lower rate of PE development with concomitant IVC filter placement than in patients without (P=0.048). | Patients receiving PEVI as treatment for acute DVT are at high risk of iatrogenic DVT and this risk may be lowered by IVC filter placement. | Treatment and Outcomes | |
| Sheu et al., (2018) [90] | USA | Prospective study (n=107) | Prophylactic IVC filters were placed in patients at high VTE-risk prior to bariatric surgery. Postoperatively, DVT occured in 3 patients (3%, 95%CI 1-9%), acute low risk PE in 1 patient (1%, 95%CI 0.3%). One required thrombolysis and the rest were managed with anticoagulation therapy. Median time of filter placement was 54 days (22-1548) and no major filter related complications. | IVC filters placed prophylactically in bariatric patients at high risk of VTE, combined with chemical prophylaxis, may be relatively low risk and help prevent development of life-threatening PE. | Surgery related | |
| Stavropoulos et al., (2016) [64] | USA | Clinical trial (n=200) | Retrievable Denali IVC filter placed in 200 patients for PE prophylaxis and followed for 2 years post-placement . Within that time period, 3% developed PE, 13% developed new or progression of existing DVT. Three cases of asymptomatic >3 mm penetration found post-retrieval. 5% filter related infection. | Retrievable Denali IVC filter can be used for temporary PE prophylaxis up to two years with a relatively low complication rate. | Filter Types | |
| Stein, Paul D. et al., (2016) [45] | USA | Retrospective cohort study (n=2,621,575) Duration: 9 years | In patients over 80 years old with stable acute PE, lower mortality was reported in those who received IVCF versus the group without filter (6.1% vs. 10.5%). | Absent a randomized control trial to verify the results, IVCF placement should be considered for elderly patients with stable acute PE. | Treatment and Outcomes | |
| Stein, Paul D. et al., (2017) [114] | USA | Retrospective cohort study (n=1,479,039) Duration: 9 years | In patients with fractures of the pelvis or long bones, the rate of all-cause mortality was 1.1% without IVCF placement, and 2.9% with IVCF. | IVCF placement did not reduce mortality in patients with pelvic or long bone fractures, and may not be useful for prophylaxis in this case. | Prophylactic Use/Trauma | |
| Stein, et al., (2018) [51] | USA | Retrospective cohort study (n=814) | IVC filters were placed in hospitalized patients with recurrent PE (within 3 months). All cause mortality with IVCF was 3% and without was 39.3% (P<0.0001). In stable patients who did not have thrombolytic therapy or pulmonary embolectomy, mortality with IVCF was 2.6% and without IVC was 42.6% (P<0.0001). | Limited data suggests that IVC filter placement in hospitalized patients with early recurrent PE have decreased all cause mortality than in patients without IVCF. | Treatment and Outcomes | |
| Stein, Paul D. et al., (2018) [48] | USA | Retrospective cohort study (n=479) Duration: 4 years | In unstable patients with acute PE, in-hospital all-cause mortality was lower in those who received IVCF versus those who did not (19.4% vs. 40.8%, P < .0001). | IVCF placement in unstable patients with acute PE seems to reduce risk of all-cause mortality if the filter is placed within the first 1-2 days of admission. | Treatment and Outcomes | |
| Stein, Paul D. et al., (2017) [46] | USA | Retrospective cohort study (n=24,495) Duration: 4 years | In patients over 60 years old with acute PE and cancer, those with IVCF had a lower risk of in-hospital all-cause mortality compared to patients without filter (7.4% vs. 11.2%, P<0.0001, relative risk 0.67). | In the subset of patients above 60 years old who have PE and cancer, IVCF may reduce the risk of all-cause in-hospital and 3-month mortality. | Treatment and Outcomes | |
| Stein, Paul D. et al., (2019) [47] | USA | Retrospective cohort study (n=4,066,513) Duration: 15 years | In patients with PE, all-cause mortality was reduced in unstable patients with IVCF compared to without (28.8% vs. 46.3%, P<0.0001). In the stable patient group, all-cause mortality was slightly reduced in the IVCF group versus the non-filter group (5.8% to 6.5%, P<0.0001). | IVCF placement in unstable patients reduces the risk of all-cause mortality, while the frequency of filter placement in these patients has decreased. Moreover, the majority of IVCF are placed in stable patients in whom there seems to be minimal reduction in all-cause mortality. | Treatment and Outcomes | |
| Stein, Paul D et al., (2020) [49] | USA | Retrospective cohort study (n=2923) Duration: 5 years | In-hospital all-cause mortality was reduced in stable patients undergoing pulmonary embolectomy in whom IVCF were placed compared to those without (4.1% vs. 27%, p <0.0001). In unstable patients undergoing pulmonary embolectomy, all-cause mortality was also reduced in the filter versus non-filter group (18% vs. 50%, p <0.0001). | Both stable and unstable patients undergoing pulmonary embolectomy had a reduced risk for all-cause mortality, provided IVCF was placed within the first 4-5 days of admission. | Treatments and Outcomes | |
| Stein, Paul D. et al., (2020) [113] | USA | Retrospective cohort study, (n=9265) Duration: 1 year | Patients with unstable PE. Anticoagulated patients with IVC suffered lower mortality rate than those without (P<0.0001). | Adjunctive therapies in combination with IVC filter may lower mortality risk in patients with unstable PE. | Prophylaxis/Trauma | |
| Swami et al., (2014) [119] | USA | Retrospective study (n=254) | Majority of IVCF placement 63.4% prophylactic placement. Of these, post-traumatic = 80.1%. Asymptomatic complications in 96 filters. | Although patients with prophylactically placed IVCFs have higher survival rates, asymptomatic complications like filter migration and IVC penetration may risk development of future problems. | Prophylaxis/Trauma | |
| Takase, Toru et al., (2020) [84] | Japan | Retrospective cohort study (n=3027) Duration: 7 years | Among 2626 patients, with acute symptomatic VTE, a total of 455 IVCF were placed and not retrieved. In the active cancer group, non-retrieved IVCF was associated with increased risk for DVT (p = 0.010) but not with decreased risk for PE (p - 0.650). An association for decreased risk for PE (p = 0.037) was found in the non cancer stratum. This group was not associated with increased risk for DVT (p = 0.108) | There are differences in the effects of IVC filter use on VTE patients with or without active cancer | Cancer Related | |
| Tapson et al., (2017) [117] | USA | Clinical trial (n=163) | Nitinol IVC filter placement used in combination with central venous catheter as PE prophylaxis in acutely ill, high-risk patients. No patient developed PE or fatal PE. 30% patients developed new or worsening DVT (7% within the first week). | Using IVC filter as a short term combination prophylactic therapy with Central Venous Catheter (CVC) may prevent significant or fatal PE in acutely ill patients. | Prophylaxis/Trauma | |
| Tran, et al., (2020) [102] | USA | Retrospective comparative study (n=1541) | In patients with severe trauma, prophylactic IVCF placement is associated with higher hazard of DVT (P=0.01), but is not associated with in-hospital PE (P=0.24) or all-cause mortality (P=0.93) | Prophylactic IVCF placement in patients with severe trauma and no prior history of VTE may increase DVT hazard without improving risk of in-hospital PE or mortality. | Prophylactic/Trauma | |
| Tsui, Brian et al., (2018) [63] | USA | Retrospective study (n=594) Duration: 88 months | In patients who received a TrapEase IVCF, 1.5% experienced breakthrough PE and recurrent DVT occurred in 18.7%. Filter fracture occurred in 13.3% of cases. | Breakthrough PE rates were similar with the TrapEase filter to other models available. Instance of filter fracture was relatively high, but there were no incidences of free fracture fragment or distant migration. | Comparison of Filter Types | |
| Tuy, Benjamin et al., (2008) [111] | USA | Retrospective cohort study (n=81) | 17 of 81 patients who underwent surgery for pelvic or lower extremity malignancies were found to have DVT when an IVC filter was placed in coordination with mechanical compression (P=0.443) | Mechanical compression in combination with IVC filter placement may be beneficial for cancer patients undergoing surgery for pelvic or lower extremity malignancy. | Prophylactic/Trauma | |
| Usoh, Fred et al., (2010) [74] | USA | Prospective randomized study (n=156) Duration: 2 years | 156 patients were randomized into 2 groups based on filter type. 84 to Greenfield, 72 to TrapEase. In a 12 month follow up, 5 patients of the TrapEase group developed symptomatic thrombosis. None developed in the Greenfield group (P = 0.19). There was no filter migration, misplacement, or perforation. | The TrapEase filter is associated with a higher rate of symptomatic IVC thrombosis. | Filter Types | |
| Van Ha, Thuong G. et al., (2007) [79] | USA | Retrospective review (n=604) Duration: 5 years | In a comparison of retrievable IVCF versus retrievable filters, the incidence of PE upon follow-up in the retrievable group was 1.4% and 1% in the permanent filter group. | The authors note filters being placed more frequently due to the prospect of retrievability, but conclude that there was a low rate of clinically significant PE or filter complications. | Filter Types | |
| Vijay, Kanupriya et al., (2011) [127] | USA | Retrospective review (n=63) Duration: 6 years | The fracture rate for Recovery, G2, and G2 Express IVC filters was 12%, and incidence of fracture increasing with longer dwelling times. Successful removal rate of non-fractured components was 98.4%, and 53.4% for the fractured components. | Rates of IVCF fracture increase with longer dwelling times, but even instances of fracture, it is possible to remove the filters safely and effectively. | Long-term Indwelling and Complications | |
| Walker, John A et al., (2021) [19] | USA? | Retrospective study (n=129) | Critically ill patients who had IVCF placement at bedside with digital radiograph were exposed to less radiation (median exposure=25 mGy) compared to patient who had IVCF placement by conventional fluoroscopy (median exposure = 256.94), P<0.0001). Duration of the digital radiography procedure was longer (14.5 +/- 2 vs 6.7+/- 6 min). | Given comparable results in technical success of IVCF filter placement, digital radiograph guided placement at bedside can reduce higher levels of radiation exposure of the conventional fluoroscopy method. | Methods of Filter Placement | |
| Wang, Stephan L. et al., (2016) [25] | USA | Retrospective study (n=96) Duration: 3 years | Study was limited to patients who had undergone contrast CTs at least 4 years after IVCF placement. Retrievable filters had higher incidence than permanent filters for perforation of IVC with or without involvement of retroperitoneal structures (P<0.0001). Also reported incidence of filter fracture and occlusion (both partial and full). | Filter type and brand may pose higher risk of certain complications; Higher rates of fracture were observed in Cordis OptEase and TrapEase filters. | Long-term Indwelling and Complications | |
| Wassef, Andrew et al., (2017) [34] | Canada | Retrospective (n=464) Duration: 4 years | IVCF placements were performed in patients with contraindication to anticoagulation in 44% of cases, while 20.7% were placed were not contraindication to anticoagulation and 30.6% were placed in patients with active cancer. | IVCF placement occurred in patients beyond the normal scope of practice, possibly introducing additional risk to patients without contraindication to anticoagulation or those with active cancer. | Treatments and Outcomes | |
| Weinberg, Ido et al., (2014) [35] | USA | Retrospective Review (n=688) Duration: 2 years | IVCF complications were found in 17.7% of patients, with DVT being the most common complication. The study further examined the relationship between IVCF placement and the commencement of anticoagulation therapy, noting that adequate anticoagulation was initiated in 66% of patients in <3 days following filter insertion. | The authors conclude that IVCF placement can be safe, but note a fairly high complication rate, combined with lack of retrieval, and delays between starting anticoagulation and retrieval. | Treatments and Outcomes | |
| Yamagami, et al., (2005) [107] | Japan | Retrospective study (n=55) | Evaluation of the Gunther Tulip retrievable IVC in patients with lower extremity DVT to prevent PE. There were no procedure associated complications. One patient experienced perforation and filter migration. Average placement time of removed filters was 4-37 days and filters were left in 24 patients due to refractory DVT. | The Gunther Tulip retrievable model can be safely placed in some patients with lower extremity DVT at risk for PE. Advantageous to have an option of retrieval if possible. Stopped reading after they mentioned case series… | Prophylaxis | |
| Yamashita, Yugo et al., (2016) [36] | Japan | Retrospective cohort study (n=257) Duration: 8 years | Study cohort was divided into two groups: IVC filter (n = 78) and No-IVC filter (n = 179). The non retrievable filter group was associated with worse mortality rate (P < 0.01) but showed no significant difference in incidences of DCT recurrence (P = 0.07) | IVC filters were frequently associated with VTE treatment but with low retrieval rates. Indications for filter placement were primarily DVT in intrapelvic or proximal veins, less commonly contraindication to anticoagulant therapy. The authors concluded that a prospective randomized trial is needed for better analysis of indications, efficacy, and associated risks. | Treatments and Outcomes | |
| Xiao, Liang et al., (2012) [20] | China | Randomized clinical trial (n=108) | Patients with DVT pre-thrombolysis had Günther IVC filters placed transfemorally with or without an introducer curving technique designed to prevent filter tilting. Filter tilt reduction was statistically significant in the test group (ACF=4.4 +/- 3.2 vs 7.1+/- 4.52 deg, P=0.001). Prior to retrieval, the rate of hook adherence to the vascular wall was also reduced in the test group (2.9% vs 24.2%, P=0.025). | Introducer curving during transfemoral placement of the Günther tulip IVCF can reduce rate and degree of filter tilting. | Methods of filter placement | |
| Ziegler et al., (2008) [67] | USA | Randomized multi-center prospective trial (n=150) | Evaluation of OptEase retrievable filter’s safety and effectiveness as a permanent option with follow-up review at 1 month and 6 month time points after filter placement. Within that time period, 4.3% filter fracture, 11.4% filter tilting. | The risks vs benefits of using retrievable filters as a long term or permanent option needs to be better understood. | Filter Types |