Advertisement

Inferior vena cava filter in patients with venous thromboembolism and major bleeding events: building the evidence

  • Alessia Abenante
  • Francesca Zuretti
  • Francesco DentaliEmail author
IM - Editorial
  • 18 Downloads

Anticoagulation is the first−line treatment in almost all patients with an acute episode of venous thromboembolism (VTE) [1]. Vena cava interruption by percutaneous insertion of an inferior vena cava filter (IVCF) is not infrequently used in these patients, with the aim of reducing mortality rate due to pulmonary embolism (PE), the most feared complication of VTE [2]. Guidelines for IVCF proper use vary among countries and professional areas [1, 3, 4, 5]. The only commonly accepted indication for IVCF would be absolute contraindication to anticoagulation therapy, such as a major bleeding complication or a very high risk of bleeding at the time of VTE [1]. Nevertheless, this recommendation is solely based on historical practice, expert opinion and case series however not supported by prospective, randomized, controlled trials. To date, only two high quality studies, the PREPIC (Prevention du Risque d’ Embolie Pulmonaire par Interruption Cave) and the PREPIC 2, assessed the efficacy and...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement on human and animal rights

This article does not contain data derived by any current studies with human participants performed by any of the authors. The clinical studies mentioned were provided with specific ethical approval.

Informed consent

For this type of study, formal consent is not required.

References

  1. 1.
    Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, Huisman M, King CS, Morris TA, Sood N, Stevens SM, Vintch JRE, Wells P, Woller SC, Moores L (2016) Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest 149:315–352.  https://doi.org/10.1016/j.chest.2015.11.026 CrossRefGoogle Scholar
  2. 2.
    Stein PD, Matta F, Hughes MJ (2017) Inferior vena cava filters in elderly patients with stable acute pulmonary embolism. Am J Med. 130(3):356–364.  https://doi.org/10.1016/j.amjmed.2016.09.033 CrossRefGoogle Scholar
  3. 3.
    Prisco D, Tufano A, Cenci C, Pignatelli P, Santilli F, Di Minno G, Perticone F (2019) Position paper of the Italian Society of Internal Medicine (SIMI) on prophylaxis and treatment of venous thromboembolism in patients with cancer. Intern Emerg Med. 14:21–38.  https://doi.org/10.1007/s11739-018-1956-1 CrossRefGoogle Scholar
  4. 4.
    Dalla Vestra M, Grolla E, Bonanni L, Pesavento R (2018) Are too many inferior vena cava filters used? Controversial evidences in different clinical settings: a narrative review. Intern Emerg Med 13:145–154.  https://doi.org/10.1007/s11739-016-1575-7 CrossRefGoogle Scholar
  5. 5.
    Mumoli N, Barco S, Cei M, Giorgi-Pierfranceschi M, Campanini M, Fontanella A, Ageno W, Dentali F (2017) Prevention and treatment of venous thromboembolism in patients with solid brain neoplasms: results of a survey among Italian physicians. Intern Emerg Med. 12:437–443.  https://doi.org/10.1007/s11739-016-1578-4 CrossRefGoogle Scholar
  6. 6.
    PREPIC Study Group (2005) Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism. Circulation 112:416–422.  https://doi.org/10.1161/circulationaha.104.512834 CrossRefGoogle Scholar
  7. 7.
    Mismetti P, Laporte S, Pellerin O et al (2015) Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. J Am Med Assoc. 313:1627–1635.  https://doi.org/10.1001/jama.2015.3780 CrossRefGoogle Scholar
  8. 8.
    Muriel A, Jiménez D, Aujesky D et al (2014) Survival effects of inferior vena cava filter in patients with acute symptomatic venous thromboembolism and a significant bleeding risk. J Am Coll Cardiol. 63:1675–1683.  https://doi.org/10.1016/j.jacc.2014.01.058 CrossRefGoogle Scholar
  9. 9.
    Mellado M, Trujillo-Santos J, Bikdeli B, Jiménez D, Núñez MJ, Ellis M, Marchena PJ, Vela JR, Farès AC, Monreal MM, The RIETE Investigators (2019) Vena caval filters in patients presenting with major bleeding during anticoagulation for venous thromboembolism. Intern Emerg Med.  https://doi.org/10.1007/s11739-019-02077-5 Google Scholar
  10. 10.
    Witt DM, Delate T, Garcia DA et al (2012) Risk of thromboembolism, recurrent hemorrhage, and death after warfarin therapy interruption for gastrointestinal tract bleeding. Arch Intern Med. 172:1484–1491.  https://doi.org/10.1001/archinternmed.2012.4261 CrossRefGoogle Scholar
  11. 11.
    Majeed A, Kim YK, Roberts RS, Holmström M, Schulman S (2010) Optimal timing of resumption of warfarin after intracranial hemorrhage. Stroke 41:2860–2866.  https://doi.org/10.1161/STROKEAHA.110.593087 CrossRefGoogle Scholar

Copyright information

© Società Italiana di Medicina Interna (SIMI) 2019

Authors and Affiliations

  1. 1.Department of Medicine and SurgeryUniversity of InsubriaVareseItaly

Personalised recommendations