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IVC Filter Removal

Andrew Buelt, DO and Neda Frayha, MD
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14:41
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No me gusta!

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A listener wrote in wondering if and when she should refer her patients with IVC filters to have these filters removed. Andrew Buelt and Neda Frayha look to the literature for some answers.

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Katina C. -

Great episode! It seems clear that we should remove filters after 5-8 weeks of they are no longer indicated, but what about people who have ongoing indications for filter (such as recurrent PE) and ongoing contraindication to anticoagulation (such as severe GI bleed)? Is there any guidance as to the risk vs benefit of that?

Also, hi Dr. Frayha! It's Katie Christopher aka Serlemitsos, former student/resident. 👋😊

Neda F., MD -

Hi Katie! It's so good to hear from you! The best evidence we have is to keep filters in as long as the indication for the filter is still there -- e.g., recurrent PE with contraindication to AC. We should focus on retrieving filters only when the need for PE prophylaxis is gone. The Journal of Vascular Surgery published an article with an interesting decision analysis tool, but this is in patients without PE. http://wayback.archive-it.org/7993/20170723125414/https://www.fda.gov/downloads/MedicalDevices/Safety/AlertsandNotices/UCM396384.pdf

I hope this helps. Thank you for listening, and please stay in touch! ☺️ Neda

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Retrieve Those Filters Full episode audio for MD edition 170:36 min - 80 MB - M4APrimary Care RAP September 2018 Written Summary-V2 590 KB - PDF

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