Inferior Vena Cava Filters in the Cancer Patient: Current Use and Indications

Authors: Todd M. Getzen MDa and John E. Rectenwald MDa
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  • a From the Department of Radiology, Section of Interventional Radiology, and the Departments of Surgery and Radiology, Sections of Vascular Surgery and Interventional Radiology, University of Michigan, Ann Arbor, Michigan.

Deep venous thrombosis and thromboembolism are significant health risks, with high rates of morbidity and mortality. Chronically ill and hospitalized patients, particularly those with cancer, have a high risk for developing these conditions. Mechanical inferior vena cava (IVC) filtration has been standard care for patients with these conditions in whom anticoagulation therapy is contraindicated or has failed. This article reviews caval filters and the current indications for using mechanical IVC filters, including retrievable versus permanent filters, focusing on their use in treating venous thromboembolism in cancer patients.

Correspondence: John E. Rectenwald, MD, 2210 F Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0325. E-mail:
  • 1.

    Streiff MB. Vena caval filters: a comprehensive review. Blood 2000;95:36693677.

  • 2.

    Hann CL, Streiff MB. The role of vena caval filters in the management of venous thromboembolism. Blood Rev 2005;19:179202.

  • 3.

    Mousa SA. Low-molecular-weight heparin in thrombosis and cancer. Semin Thromb Hemost 2004;30(suppl 1):2530.

  • 4.

    Baldridge ED, Martin MA, Welling RE. Clinical significance of free-floating venous thrombi. J Vasc Surg 1990;11:6267.

  • 5.

    Pacouret G, Alison D, Pottier JM et al. . Free-floating thrombus and embolic risk in patients with angiographically confirmed proximal deep venous thrombosis. A prospective study. Arch Intern Med 1997;157:305308.

    • Search Google Scholar
    • Export Citation
  • 6.

    Radomski JS, Jarrell BE, Carabasi RA et al. . Risk of pulmonary embolus with inferior vena cava thrombosis. Am Surg 1987;53:97101.

  • 7.

    Rutherford RB. Prophylactic indications for vena cava filters: critical appraisal. Semin Vasc Surg 2005;18:158165.

  • 8.

    Greenfield LJ, Proctor MC. Twenty-year clinical experience with the Greenfield filter. Cardiovasc Surg 1995;3:199205.

  • 9.

    Roehm JO Jr, Gianturco C, Barth MH et al. . Percutaneous transcatheter filter for the inferior vena cava. A new device for treatment of patients with pulmonary embolism. Radiology 1984;150:255257.

    • Search Google Scholar
    • Export Citation
  • 10.

    Hoff WS, Hoey BA, Wainwright GA et al. . Early experience with retrievable inferior vena cava filters in high-risk trauma patients. J Am Coll Surg 2004;199:869874.

    • Search Google Scholar
    • Export Citation
  • 11.

    Decousus H, Leizorovicz A, Parent F et al. . A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep vein thrombosis. N Engl J Med 1998;338:409415.

    • Search Google Scholar
    • Export Citation
  • 12.

    PREPIC Study Group. Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC (Prévention du Risque d'Embolie Pulmonaire par Interruption Cave) randomized study. Circulation 2005;112:416422.

    • Search Google Scholar
    • Export Citation
  • 13.

    Binkert CA, Sasadeusz K, Stavropoulos SW. Retrievability of the recovery vena cava filter after dwell times longer than 180 days. J Vasc Interv Radiol 2006;17(2 Pt 1):299302.

    • Search Google Scholar
    • Export Citation
  • 14.

    Becker DM, Philbrick JT, Selby JB. Inferior vena cava filters. Indications, safety, effectiveness. Arch Intern Med 1992;152:19851994.

  • 15.

    Joels CS, Sing RF, Heniford BT. Complications of inferior vena cava filters. Am Surg 2003;69:654659.

  • 16.

    Athanasoulis CA. Complications of vena cava filters. Radiology 1993;188:614615.

  • 17.

    David W, Gross WS, Colaiuta E et al. . Pulmonary embolus after vena cava filter placement. Am Surg 1999;65:341346.

  • 18.

    Athanasoulis CA, Kaufman JA, Halpern EF et al. . Inferior vena caval filters: review of a 26-year single-center clinical experience. Radiology 2000;216:5466.

    • Search Google Scholar
    • Export Citation
  • 19.

    Greenfield L, Proctor M. Recurrent thromboembolism in patients with vena cava filters. J Vasc Surg 2001;33:510514.

  • 20.

    Trosseau A. Phlegmasia alba dolens. In: Clinique Medicale de l'Hotel Dieu de Paris. 2nd edition. Paris: Balliere, 1865.

  • 21.

    Caine GJ, Stonelake PS, Lip GY et al. . The hypercoagulable state of malignancy: pathogenesis and current debate. Neoplasia 2002; 4:465473.

  • 22.

    Lin J, Proctor MC, Varma M et al. . Factors associated with recurrent venous thromboembolism in patients with malignant disease. J Vasc Surg 2003;37:976983.

    • Search Google Scholar
    • Export Citation
  • 23.

    Gitter MJ, Jaeger TM, Petterson TM et al. . Bleeding and thromboembolism during anticoagulant therapy: a population-based study in Rochester, Minnesota. Mayo Clin Proc 1995;70:725733.

    • Search Google Scholar
    • Export Citation
  • 24.

    Prandoni P, Lensing AW, Piccioli A et al. . Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood 2002;100:34843488.

    • Search Google Scholar
    • Export Citation
  • 25.

    Ihnat DM, Mills JL, Hughes JD et al. . Treatment of patients with venous thromboembolism and malignant disease: should vena cava filter placement be routine? J Vasc Surg 1998;28:800807.

    • Search Google Scholar
    • Export Citation
  • 26.

    Krauth D, Holden A, Knapic N et al. . Safety and efficacy of long-term oral anticoagulation in cancer patients. Cancer 1987;59:983985.

  • 27.

    Jarrett B, Dougherty M, Calligaro K. Inferior vena cava filters in malignant disease. J Vasc Surg 2002;36:704707.

  • 28.

    Marcy PY, Magne N, Gallard JC et al. . Cost-benefit assessment of inferior vena cava filter placement in advanced cancer patients. Support Care Cancer 2002;10:7680.

    • Search Google Scholar
    • Export Citation
  • 29.

    Donaldson MC, Wirthlin LS, Donaldson GA. Thirty-year experience with surgical interruption of the inferior vena cava for prevention of pulmonary embolism. Ann Surg 1980;191:367372.

    • Search Google Scholar
    • Export Citation
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