Der Radiologe · 2013
[Vena cava filter. Which indications remain in the era of differentiated anticoagulation?].
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Mahnken A H
Аннотация
CLINICAL/METHODICAL ISSUE: Venous thromboembolism (VTE) is the third most common disease of the cardiovascular system. It is associated with a 30-day lethality in the range of 6 % in deep vein thrombosis and 12 % in pulmonary embolism (PE). There are various guidelines with sometimes controversial recommendations regarding the use of inferior vena cava (IVC) filters.
STANDARD RADIOLOGICAL METHODS: Implantation of IVC filters is a standard therapy in selected patients with an estimated 259,000 filters implanted in 2012.
METHODICAL INNOVATIONS: Optionally retrievable filters are increasingly being used in clinical routine practice. Future developments will include biodegradable and drug-eluting filters.
PERFORMANCE: When compared to anticoagulation as the reference therapy of VTE, IVC filters will significantly reduce the frequency of symptomatic PE; however, there is no advantage in overall survival for either therapy.
ACHIEVEMENTS: Despite different guidelines in clinical routine practice the use of IVC filters appears to depend on the individual clinical experience and assessment of the interventionalist.
PRACTICAL RECOMMENDATIONS: Nowadays retrievable filters should be used although there are relevant differences between the various devices. As a matter of principle all IVC filters should be removed as soon as adequate anticoagulation can be established.
STANDARD RADIOLOGICAL METHODS: Implantation of IVC filters is a standard therapy in selected patients with an estimated 259,000 filters implanted in 2012.
METHODICAL INNOVATIONS: Optionally retrievable filters are increasingly being used in clinical routine practice. Future developments will include biodegradable and drug-eluting filters.
PERFORMANCE: When compared to anticoagulation as the reference therapy of VTE, IVC filters will significantly reduce the frequency of symptomatic PE; however, there is no advantage in overall survival for either therapy.
ACHIEVEMENTS: Despite different guidelines in clinical routine practice the use of IVC filters appears to depend on the individual clinical experience and assessment of the interventionalist.
PRACTICAL RECOMMENDATIONS: Nowadays retrievable filters should be used although there are relevant differences between the various devices. As a matter of principle all IVC filters should be removed as soon as adequate anticoagulation can be established.