Answer IVC filter

Pulmonary embolism is a significant cause of morbidity and mortality. Normally patients with DVT or PE are treated with anticoagulation therapy. As many as 20% of patients will have recurrent thrombo embolic events. The purpose of IVC filters is to prevent thrombi generated in the pelvic veins and lower limbs embolising to the right side of the heart and into the pulmonary circulation (Fig. 6.29). Ideally, highly efficient filtration without impedance of blood flow is required (Table 6.5).

Fig. 6.29 IVC filter note abundant clot proximal to it.

Table 6.5 Indications for IVC filters

Accepted indications

1. Contraindication to anticoagulation

2. Complication of anticoagulation

3. Failure of anticoagulation recurrent PE or inability to achieve adequate anticoagulation

4. Massive PE with residual DVT in patient at risk of further PE

Further indications

1. Severe trauma without documented PE or DVT; closed head injury, spinal cord injury, multiple long bone or pelvic fractures

2. High-risk patients, intensive care patients

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