Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2025, 34(1):29-40

Caval filter - indications, extractions and complications

Marek Hudák, Martin Koščo, Lucia Dekanová, Veronika Pavlíková, Mária Rašiová
Klinika angiológie LF UPJŠ a VÚSCH, a. s., Košice, Slovenská republika

The inferior vena cava filter can prevent pulmonary embolism by mechanically capturing an embolus in the inferior vena cava. Despite its indisputable effectiveness in the prevention of pulmonary embolism in a selected group of patients, its use is associated with considerable controversy, especially in the last two decades. The introduction of extractable filters into clinical practice resulted in the emergence of a constellation of relative indications, and significantly increased the rate of filter implantation. This also led to a disproportionate increase in complications. The purpose of this article is to summarize the most current indications for filter insertion, and possible complications related to the use and extraction of the caval filter.

Keywords: deep vein thrombosis; inferior vena caval filter; pulmonary embolism; indications for implantation; complications; retrieval

Published: January 1, 2025  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Hudák M, Koščo M, Dekanová L, Pavlíková V, Rašiová M. Caval filter - indications, extractions and complications. Cardiology Letters. 2025;34(1):29-40.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. DeYoung E, Minocha J. Inferior Vena Cava Filters: Guidelines, Best Practice, and Expanding Indications. Semin Intervent Radiol. 2016;33:65-70. Go to original source...
    2. Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, et al. ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41:543-603. Go to original source...
    3. Kaufman JA, Barnes GD, Chaer RA, Cuschieri J, Eberhardt RT, Johnson MS, et al. Society of Interventional Radiology Clinical Practice Guideline for Inferior Vena Cava Filters in the Treatment of Patients with Venous Thromboembolic Disease: Developed in collaboration with the American College of Cardiology, American College of Chest Physicians, American College of Surgeons Committee on Trauma, American Heart Association, Society for Vascular Surgery, and Society for Vascular Medicine. J Vasc Interv Radiol. 2020;1529-1544. Go to original source...
    4. Ortel TL, Neumann I, Ageno W, Beyth R, Clark NP, Cuker A, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020;4:4693-4738. Go to original source...
    5. Kakkos SK, Gohel M, Baekgaard N, Bauersachs R, Bellmunt-Montoya S, Black SA, et al. Editor's Choice - European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis. Eur J Vasc Endovasc Surg. 2021;61:9-82. Go to original source...
    6. Stevens SM, Woller SC, Kreuziger LB, Bounameaux H, Doerschug K, Geersing GJ, et al. Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report. Chest. 2021;160:e545-e608. Go to original source...
    7. Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, BlomströmLundqvist C et al. ESC Scientific Document Group. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42:373-498. Go to original source...
    8. Adderley N, Ryan R, Marshall T. The role of contraindications in prescribing anticoagulants to patients with atrial fibrillation: a cross-sectional analysis of primary care data in the UK. Br J Gen Pract. 2017;67:e588-e597. Go to original source...
    9. Kuyumcu G, Walker TG. Inferior vena cava filter retrievals, standard and novel techniques. Cardiovasc Diagn Ther. 2016;6:642-650. Go to original source...
    10. Davies R, Stanley J, Wickremesekera J, Khashram M. Retrieval rates of inferior vena cava (IVC) filters: are we retrieving enough? N Z Med J. 2015;128:31-40.
    11. Tao MJ, Montbriand JM, Eisenberg N, Sniderman KW, RocheNagle G. Temporary inferior vena cava filter indications, retrieval rates, and follow-up management at a multicenter tertiary care institution. J Vasc Surg. 2016;64:430-437. Go to original source...
    12. Desai KR, Laws JL, Salem R, Mouli SK, Errea MF, Karp JK, et al. Defining Prolonged Dwell Time: When Are Advanced Inferior Vena Cava Filter Retrieval Techniques Necessary? An Analysis in 762 Procedures. Circ Cardiovasc Interv. 2017;10:1-5. Go to original source...
    13. Ahmed O, Kim YJ, Patel MV, Tullius TG, Jr, Navuluri R, Funaki B, et al. A single-institutional comparative analysis of advanced versus standard snare removal of inferior vena cava filters. J Vasc Interv Radiol. 2020;31:53-60. Go to original source...
    14. Al-Hakim R, Kee ST, Olinger K, Lee EW, Moriarty JM, McWilliams JP. Inferior vena cava filter retrieval: effectiveness and complications of routine and advanced techniques. J Vasc Interv Radiol. 2014;25933-25939. Go to original source...
    15. Schuchardt P, Kis L, Goloubev A, Keshishian E, Mhaskar R, Hoots G, et al. Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center. CVIR Endovasc. 2022;5:39. Go to original source...
    16. Kethidi N, Barsoum K, Shukla PA, Kumar A. Inferior vena cava filter retrievals using advanced techniques: a systematic review. Diagn Interv Radiol. 2023;29:500-508. Go to original source...
    17. Su Q, Ding X, Dong Z, Liu Y, Li G, Jiang J. A modified loop snare technique for difficult retrievals of inferior vena cava filter and migrated coil. Int Heart J. 2019;60:93-99. Go to original source...
    18. Desai TR, Morcos OC, Lind BB, Schindler N, Caprini JA, Hahn D, et al. Complications of indwelling retrievable versus permanent inferior vena cava filters. J Vasc Surg Venous Lymphat Disord. 2014;2:166-173. Go to original source...
    19. Quencer KB, Smith TA, Deipolyi A, Mojibian H, Ayyagari R, Latich I, et al. Procedural complications of inferior vena cava filter retrieval, an illustrated review. CVIR Endovasc. 2020;3:23. Go to original source...
    20. Laws JL, Lewandowski RJ, Ryu RK, Desai KR. Retrieval of Inferior Vena Cava Filters: Technical Considerations. Semin Intervent Radiol. 2016;33:144-148. Go to original source...
    21. Clements W, Moriarty HK, Paul E, Goh GS. Stratification of Preprocedure Risk Factors Associated with Difficult-to-remove Inferior Vena Cava (IVC) Filters: A 6-year Retrospective Analysis at a Tertiary Center. Cardiovasc Intervent Radiol. 2020;43:238245. Go to original source...
    22. Dinglasan LA, Oh JC, Schmitt JE, Trerotola SO, Shlansky-Goldberg RD, Stavropoulos SW. Complicated inferior vena cava filter retrievals: associated factors identified at preretrieval CT. Radiology. 2013;266:347-354. Go to original source...
    23. Giannoudis PV, Pountos I, Pape HC, Patel JV. Safety and efficacy of vena cava filters in trauma patients. Injury. 2007;38:7-18. Go to original source...
    24. Li X, Haddadin I, McLennan G, Farivar B, Staub D, Beck A, et al. Inferior vena cava filter - comprehensive overview of current indications, techniques, complications and retrieval rates. Vasa. 2020;49:449-462. Go to original source...
    25. Korbin CD, Van Allan RJ, Andrews RT, Katz MD, Teitelbaum GP. Strut interlocking of titanium Greenfield vena cava filters and its effect on clot capturing: an in vitro study. Cardiovasc Intervent Radiol. 1994;17:204-206. Go to original source...
    26. Günther RW, Neuerburg J, Mossdorf A, Pfeffer J, Høj AR, Mølgaard-Nielsen A, et al. New optional IVC filter for percutaneous retrieval-in vitro evaluation of embolus capturing efficiency. Rofo. 2005;177:632-636. Go to original source...
    27. Grassi CJ, Swan TL, Cardella JF, Meranze SG, Oglevie SB, Omary RA, et al. Society of Cardiovascular & Interventional Radiology, Standards of Practice Committee. Quality improvement guidelines for percutaneous permanent inferior vena cava filter placement for the prevention of pulmonary embolism. SCVIR Standards of Practice Committee. J Vasc Interv Radiol. 2001;12:137-141. Go to original source...
    28. Jia Z, Wu A, Tam M, Spain J, McKinney JM, Wang W. Caval Penetration by Inferior Vena Cava Filters: A Systematic Literature Review of Clinical Significance and Management. Circulation. 2015;132:944-952. Go to original source...
    29. Gwon JG. Structural Injury of Adjacent Organs Due to Inferior Vena Cava Filter Penetration. Ann Phlebology 2020;18:55-58. Go to original source...
    30. Duncan C, Trerotola SO, Stavropoulos SW. Endovascular Removal of Inferior Vena Cava Filters with Arterial Penetration. J Vasc Interv Radiol. 2018;29:486-490. Go to original source...
    31. Holly BP, Gaba RC, Lessne ML, Lewandowski RJ, Ryu RK, Desai KR, et al. Vena Cava Filter Retrieval with Aorto-Iliac Arterial Strut Penetration. Cardiovasc Intervent Radiol. 2018;41:1184-1188. Go to original source...
    32. Hong M Jr, Brown MA, Ryu RK. Mechanism and Approach to Fractured Filters, In: Desai KR, Ahmed O, Van Ha T, eds. Placement and Retrieval of Inferior Vena Cava Filters. A Case-Based Approach. Cham: Springer Nature Switzerland AG; 2020:113-130. Go to original source...
    33. Wang W, Zhou D, Obuchowski N, Spain J, An T, Moon E. Fracture and migration of Celect inferior vena cava filters: a retrospective review of 741 consecutive implantations. J Vasc Interv Radiol. 2013;24:1719-1722. Go to original source...
    34. Vijay K, Hughes JA, Burdette AS, Scorza LB, Singh H, Waybill PN, et al. Fractured Bard Recovery, G2, and G2 express inferior vena cava filters: incidence, clinical consequences, and outcomes of removal attempts. J Vasc Interv Radiol. 2012;23:188-194. Go to original source...
    35. Peters MN, Khazi Syed RH, Katz MJ, Moscona JC, Nijjar VS, Bisharat MB. Inferior vena cava filter migration to the right ventricle causing nonsustained ventricular tachycardia. Tex Heart Inst J. 2013;40:316-319.
    36. Nazzal M, Chan E, Nazzal M, Abbas J, Erikson G, Sediqe S, et al. Complications related to inferior vena cava filters: a singlecenter experience. Ann Vasc Surg. 2010 May;24:480-486. Go to original source...
    37. Zhu X, Tam MD, Bartholomew J, Newman JS, Sands MJ, Wang W. Retrievability and device-related complications of the G2 filter: a retrospective study of 139 filter retrievals. J Vasc Interv Radiol. 2011;22:806-812. Go to original source...
    38. Owens CA, Bui JT, Knuttinen MG, Gaba RC, Carrillo TC, Hoefling N, et al. Intracardiac migration of inferior vena cava filters: review of published data. Chest. 2009;136:877-887. Go to original source...
    39. Andreoli JM, Thornburg BG, Hickey RM. Inferior Vena Cava Filter-Related Thrombus/Deep Vein Thrombosis: Data and Management. Semin Intervent Radiol. 2016;33:101-104. Go to original source...
    40. Hajduk B, Tomkowski WZ, Malek G, Davidson BL. Vena cava filter occlusion and venous thromboembolism risk in persistently anticoagulated patients: a prospective, observational cohort study. Chest 2010;137:877-882. Go to original source...
    41. Ahmad I, Yeddula K, Wicky S, Kalva SP. Clinical sequelae of thrombus in an inferior vena cava filter. Cardiovasc Intervent Radiol 2010;33:285-289. Go to original source...
    42. Lessne ML, Holly B. Management of the Acute Thrombus-Bearing IVC Filter, In: Desai KR, Ahmed O, Van Ha T, eds. Placement and Retrieval of Inferior Vena Cava Filters. A Case-Based Approach. Cham: Springer Nature Switzerland AG; 2020:177-188. Go to original source...
    43. Chick JFB, Jo A, Meadows JM, Abramowitz SD, Khaja MS, Cooper KJ, et al. Endovascular Iliocaval Stent Reconstruction for Inferior Vena Cava Filter-Associated Iliocaval Thrombosis: Approach, Technical Success, Safety, and Two-Year Outcomes in 120 Patients. J Vasc Interv Radiol. 2017;28:933-939. Go to original source...
    44. Desai KR, Xiao N, Karp J, Salem R, Rodriguez H, Eskandari M, et al. Single-session inferior vena cava filter removal, recanalization, and endovenous reconstruction for chronic iliocaval thrombosis. J Vasc Surg Venous Lymphat Disord. 2019;7:176-183. Go to original source...
    45. Klepitch ET, Desai KR. Management of Filter-Related Chronic Iliocaval Occlusion, In: Desai KR, Ahmed O, Van Ha T, eds. Placement and Retrieval of Inferior Vena Cava Filters. A Case-Based Approach. Cham: Springer Nature Switzerland AG; 2020:189-202. Go to original source...
    46. Grewal S, Lewandowski RJ, Ryu RKW, Desai KR. Inferior Vena Cava Filter Retrieval: Patient Selection, Procedural Planning, and Postprocedural Complications. AJR Am J Roentgenol. 2020;215:790-794. Go to original source...

    Return to the content