IVC Filters: Temporary or Permanent?

By | January 2, 2014

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If you clicked on this article, you know what an IVC filter’s job is: prevent pulmonary embolism. The largest study on following people with retrievable IVC filters supports the guidelines generated by the SIR: Society of Interventional Radiology.

An IVC filter can be placed temporarily or permanently. Timothy P. Murphy, MD, is SIR’s president. He affirms that SIR is well-aware of the debate regarding temporary vs. permanent IVC filter. IVC stands for inferior vena cava (a large vein involved in circulation).

A blood clot in a deep vein is called a deep vein thrombosis (DVT). If the clot breaks loose and travels to the lung, it becomes a pulmonary embolus, which can choke off a person’s oxygen supply in seconds. The U.S. Surgeon General says that between 100,000 and 180,000 Americans die yearly from a PE.

Most people with DVT are treated with a blood thinner drug, which usually prevents pulmonary embolus. An IVC filter will block a migrating DVT from getting into the lungs. Some people are not suitable candidates for blood thinners, such as trauma patients. There’s also people who, despite being treated with blood thinners, develop DVT anyways.

In 2007, 167,000 IVC filters were placed. In 2012, at least a quarter of a million were placed. Most of these filters were meant to be permanent. A type called “retrievable” can be later removed by a doctor.

However, some retrievable IVC filters can fracture or even migrate to other portions of the bloodstream. The FDA has recommended that doctors who implant these devices routinely consider the risk/benefit ratio for every patient. Removal should be considered for patients no longer at risk for PE.

“Because retrievable filters may need to be removed within four to six weeks of placement, after which they may become too firmly attached to the inferior vena cava to be removable, it is important that individuals remain in contact with their physicians during that time to discuss the filter’s possible removal,” remarks Charles E. Ray, Jr., MD, an interventional radiologist.

Dr. Ray adds that the barriers to removing IVC filters are primarily selection of patients and patients losing touch with their doctors during the important follow-up period.

SIR’s guidelines are: Close communication between physician and patient; patients with IVC filters should speak to their interventional radiologists as well as other doctors regarding any questions or concerns. This includes when IVC filter removal may be an option. A “retrievable” filter may actually remain permanently in the patient and should have FDA approval for such.

Source: sciencedaily.com/releases/2011/11/111128121545.htm

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