A filter in the inferior vena cava can prevent an embolus from the deep veins of the lower extremity or pelvis from reaching the lungs. However, these devices can have complications so should only be used if the benefit is greater than the risk.


Definite indications for placement of a filter in the inferior vena cava:

(1) pulmonary embolism in a patient with contraindications to anticoagulation

(2) recurrent pulmonary embolism despite adequate anticoagulation


Controversial indications for filter placement:

(1) deep vein thrombosis with contraindications to anticoagulation

(2) deep vein thrombosis in a patient with pulmonary hypertension

(3) free floating thrombus in a proximal vein

(4) failure of an existing filter device

(5) status post pulmonary embolectomy


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