Physician Practice Patterns on The Use Of Inferior Vena Cava Filters For Venous Thromboembolism

While anticoagulation remains the first line of treatment for acute deep vein thrombosis (DVT) and pulmonary embolism (PE), use of inferior vena cava filters (IVCFs) has increased in recent decades. IVCFs were designed to trap thrombus originating in lower extremity veins to prevent the development of clinically significant PE. Data demonstrating the effectiveness of IVCFs in reducing thrombosis-related morbidity are lacking, however. A survey investigating physician practices for inferior vena cava (IVC) filter use, given the increase in usage despite uncertain benefits in reducing thrombosis mortality and varied guidelines, received 53 responses, primarily from hematologists/thrombosis physicians (39.6%) in academic settings (44.26%). Half reported no filter removal protocols. Faced with acute pulmonary embolism (PE) and contraindication to anticoagulation without leg DVT, 43.64% would use a filter, while 52.73% preferred serial ultrasounds. For proximal leg DVT diagnosed 2 days before an anticoagulation contraindication, 60% considered a filter, dropping to 27.3% for DVT occurring 3 weeks prior. Results indicate diverse IVCF use and underscore the need for clearer guidelines on their application in complex cases and post-insertion monitoring.