Guidelines for the Use of Retrievable and Convertible Vena Cava Filters: Report from the Society of Interventional Radiology Multidisciplinary Consensus Conference

• DOI: 10.1097/01.rvi.0000203418-39769.0d
• Publication Date: 2010-03-22T13:47:53Z
• Authors: John A. Kaufman; Thomas B. Kinney; Michael B. Streiff; Ronald F. Sing; Mary C. Proctor; Daniel Becker; Mark Cipolle; Anthony J. Comerota; Steven F. Millward; Frederick B. Rogers; David Sacks; Anthony C. Venbrux
• Keywords: Vena cava filters

REMOVABLE vena cava filters for temporary protection from pulmonary embolism (PE) were first proposed in 1967 (1). In 2003 and 2004, the United States Food and Drug Administration approved changes to the instructions for use of three existing permanent filters to allow percutaneous retrieval (2). Filter retrieval was added to the instructions without modification of the indications for placement or the addition of indications for retrieval. The instructions for use provide physicians with minimal guidance for the use of these devices as removable filters. Many medical specialties are involved in requesting and placing filters as well as subsequent patient management. The overall use of vena cava filters may be increased by the availability of nonpermanent devices (3). However, there is a paucity of medical literature on these filters (4). On January 14 and 15, 2005, the Society of Interventional Radiology (SIR) convened a multidisciplinary conference to address the clinical application of nonpermanent vena cava filters. Representatives from interventional radiology, trauma surgery, vascular surgery, and internal medicine participated. The goal of the consensus conference was to develop a document that would provide clinical guidance for all physicians who use these vena cava filters. Specifically, we sought to address the indications for placement of a nonpermanent filter, the management of patients with such a filter in situ, the conditions for discontinuation of caval filtration, the evaluation of patients before discontinuation, and patient management after discontinuation. Filter design, performance, reporting standards, quality assurance, and recommendations for specific device selection were not included in the discussions (5–7).