September 9, 2020
Clinical Practice Guidelines on IVC Filter Use Published
September 9, 2020—The Society of Interventional Radiology announced that new clinical practice guidelines developed by a multidisciplinary panel on the use of inferior vena cava (IVC) filters in patients with venous thromboembolism (VTE) were published by John A. Kaufman, MD, et al online in Journal of Vascular & Interventional Radiology.
According to SIR, the evidence-based guidelines advise against the routine placement of IVC filters in most VTE cases where patients are being successfully treated with anticoagulants. However, if anticoagulation therapies fail or are not indicated for the patient, IVC filters may be considered as a treatment option if clinical risk factors such as bleeding, vascular injury, device migration, and increased risk of recurrent deep vein thrombosis (DVT) are considered and deemed low.
When IVC filters are placed, the guidelines recommend a follow-up program to increase retrieval and detect complications. In addition, if patients with retrievable IVC filters are no longer at risk of developing a pulmonary embolism, the guidelines recommend removal unless the risk outweighs the benefits.
“These guidelines allow physicians treating patients at risk of a pulmonary embolism to make evidence-based decisions about the use of IVC filters,” commented Dr. Kaufman in the SIR announcement. “Throughout the process, the multidisciplinary team followed a gold-standard methodology to ensure we reached the best possible consensus on VTE patient care.” Dr. Kaufman is chair of the department of interventional radiology at Oregon Health & Science University in Portland, Oregon.
SIR President Michael D. Dake, MD, added, “With these multidisciplinary guidelines, the authors have removed any inconsistencies and uncertainties older guidelines may have presented physicians treating patients with VTE. The authors should be proud of this achievement.” Dr. Dake is senior vice president of the University of Arizona Health Sciences in Tucson, Arizona.
SIR noted that this is the society's first official clinical practice guideline, developed using gold-standard guideline methodology following the Standards for Trustworthy Clinical Practice Guidelines set by the National Academy of Medicine.
The guidelines were developed in collaboration with and endorsed by the American College of Cardiology, the American Heart Association/American Stroke Association, American College of Surgeons (Committee on Trauma), American College of Chest Physicians (CHEST), Society for Vascular Medicine, Society for Vascular Surgery. The Canadian Association for Interventional Radiology and Cardiovascular and Interventional Radiological Society of Europe have also endorsed the guidelines. The American Society of Hematology has affirmed the value of the statement, advised SIR.