How Retrievable are “Retrievable” IVC Filters?
Pulmonary embolisms (PE) are a serious health risk, especially if the condition goes undiagnosed. According to the Mayo Clinic, about 1/3 of people with undiagnosed and untreated pulmonary embolisms do not survive. While blood thinners are the most common treatment for PE, many people are unable or unwilling to take anticoagulant medication. In cases like these, inferior vena cava filters (IVC filters) are often used as an alternative.
The inferior vena cava (IVC) is a large vein that carries deoxygenated blood from the lower body into the heart. IVC Filters are spider-like wire is inserted into the inferior vena cava to catch clots in the bloodstream before they reach vital organs, breaking them down over time.
People who are considered to be at non-permanent risk of PE, such as trauma patients, are often implanted with a “retrievable” IVC filter. These are designed to remain in place until the risk of PE has passed.
In 2010, the FDA issued a safety communication advising doctors responsible for the ongoing care of patients with retrievable IVC filters that the devices should be removed as soon as protection from PE is no longer needed. Despite this warning, a 2011 meta-analysis of 37 studies revealed that, based on the information available to them, retrievable IVC filters were removed only one-third of the time. The research goes on to conclude that multiple complications associated with the use of retrievable IVC filters were associated with long-term use lasting more than 30 days, including filter migration, fractures, and perforation.
Similar to the removal of Essure permanent birth control devices, one of the contributing factors these devices are not removed is due to the difficulty of the extraction process. Risk of residual deep vein thrombosis, the entrapment of significant thrombus, and other technical issues have all been listed as contributing factors to leaving retrievable IVC filters in long after the threat of PE has passed.
Disclaimer: This article has been prepared for general information purposes and does not constitute medical or legal advice, nor does it imply an attorney-client relationship or contract with Wexler Wallace.