Inferior Vena Cava (IVC) Filter: Indications

Figure 1 and 2: Frontal view of the scout angiographic image (1) and axial CT image (2) show an IVC filter (arrows).

IVC Filter

• Does prevent pulmonary embolus (PE) by trapping venous emboli
• Does not prevent new thrombus formation
• Does not promote lysis of preexisting thrombus

Absolute Indications

1. Documented deep vein thrombosis (DVT) and/or PE but cannot be anticoagulated
2. Documented progression of DVT or recurrent PE while anticoagulated
3. Complication of anticoagulation that requires anticoagulants to be terminated
4. Massive, life-threatening PE that requires thrombosis or surgical thrombectomy
5. Recurrent PE due to failed existing IVC filter

Relative Indications

1. Documented DVT and/or PE and limited cardiac or pulmonary reserve, poor compliance with medications, fall risk, inability to monitor
2. Large burden of clot in extremity veins
3. Patients with past history of DVT and/or PE that will undergo operation (i.e. knee replacement, craniotomy) with high-risk of postoperative DVT/PE
4. Patients at high risk of developing DVT and/or PE (i.e. multiple trauma)

Reference:

Kaufman JA. Vena Caval Filters. In: Kandarpa K and Aruny JE, eds. Handbook of interventional radiologic procedures. 3rd ed. 2002.