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Vena Cava Filters Reduce Pulmonary Emboli But Increase VTE Recurrence Tenfold — Physician’s First Watch

Medical News |
March 6, 2014

Vena Cava Filters Reduce Pulmonary Emboli But Increase VTE Recurrence Tenfold

By Joe Elia

Inferior vena cava filters seem to offer protection against death from pulmonary embolism when compared with anticoagulant therapy, but they have no significant effect on all-cause mortality. In addition, the filters are associated with higher rates of recurrent venous thromboembolism, according to an article in the Journal of the American College of Cardiology.

Researchers examined data from some 40,000 patients with VTE, 344 of whom received filters because of their increased risks for bleeding (they could also receive anticoagulants). The filter recipients were matched with 344 controls on anticoagulants only.

By 30 days, the all-cause mortality rate (the primary endpoint) did not differ between the groups. A secondary endpoint, death from pulmonary embolism, favored the filter group over the controls (1.7% vs. 4.9%). However, the rate of recurrent VTE was tenfold higher among filter recipients (6.1% vs. 0.6%).

An editorialist writes that the finding on pulmonary embolism deaths "suggests that filters offer clinical benefits that are discrete from those conferred by anticoagulation."

Editor's note: Although the embargo for the study has lifted, it has not yet appeared online. We have provided a link to JACC's Online First page, where the article should eventually appear.

Reader Comments (2)

ALFREDO KAMINKER Physician, Hematology

Patients who get filters usually do not receive anticogulation at least at frontline .Am i´ wrong?

Cynthia Steimle MD Physician, Surgery, Specialized

I can't access the paper to get more detail, but it appears that the patients who received filters did not get anticoagulation and they were compared to patients who got anticoagulation but no filter. So of course the patients who did not get anti coagulation had more recurrence of DVT . Having a filter didn't cause the DVT to occur - the lack of anti coagulation did (or at least fidm't prevent it). Or am I missing something?

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