Wondering about the pros and cons of retrievable IVC filters vs. permanent ones?
Since you’re here you probably 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.
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.
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.
Some Big Considerations
“In 2019, if a filter is deemed necessary, it probably should be a retrievable one, but plans need to be made for removal at the time of placement,” says Steve Elias, MD, FACS, director of Center for Vein Disease and The Wound Healing Center at Englewood Hospital and Medical Center in Englewood, NJ.
“The biggest problem with retrievable filters is that they are not retrieved,” continues Dr. Elias. “They work well. If one is 100% sure it never needs removal, then a permanent filter should be placed.”
A retrievable filter may need to be taken out within four to six weeks of placement. Waiting too long for removal would give the filter a chance to become too firmly attached to the inferior vena cava to be removable.
One of the reasons a retrievable filter may end up in the patient’s body too long is that the patient loses touch with their doctor during the crucial follow-up period.
Hence, selection of which patients should receive a retrievable IVC is very important.
- Patients with retrievable IVCs or who are being considered for one should have very close communication with their doctor.
- Those with the filters should talk to their interventional radiologist, plus other physicians, about any concerns.