Ibero-American Society of Interventionism (SIDI) and the Spanish Society of Vascular and Interventional Radiology (SERVEI) Standard of Practice (SOP) for the Management of Inferior Vena Cava Filters in the Treatment of Acute Venous Thromboembolism.

M.a De Gregorio ,Héctor Ferral ,Elena Lonjedo ,William T Kuo ,Mariano Magallanes ,George Behrens ,Sergio Sierre ,Carolina Serrano-Casorrán ,Eduardo Eyheremendy ,José Urbano ,S Méndez ,Juan José Ciampi-Dopazo ,Juan D Pulido ,Micaela Arrieta ,Carlos Lanciego ,Guadalupe Guerrero ,Cristina Bonastre ,J M Abadal ,Pedro Pardo ,Maria C Perez Perez ,Jimena González-Nieto ,José Rodríguez-Gómez ,Jose Guirola ,David Jiménez

doi:10.3390/jcm11010077

Abstract

Objectives: to present an interventional radiology standard of practice on the use of inferior vena cava filters (IVCFs) in patients with or at risk to develop venous thromboembolism (VTE) from the Iberoamerican Interventional Society (SIDI) and Spanish Vascular and Interventional Radiology Society (SERVEI). Methods: a group of twenty-two interventional radiologist experts, from the SIDI and SERVEI societies, attended online meetings to develop a current clinical practice guideline on the proper indication for the placement and retrieval of IVCFs. A broad review was undertaken to determine the participation of interventional radiologists in the current guidelines and a consensus on inferior vena cava filters. Twenty-two experts from both societies worked on a common draft and received a questionnaire where they had to assess, for IVCF placement, the absolute, relative, and prophylactic indications. The experts voted on the different indications and reasoned their decision. Results: a total of two-hundred-thirty-three articles were reviewed. Interventional radiologists participated in the development of just two of the eight guidelines. The threshold for inclusion was 100% agreement. Three absolute and four relative indications for the IVCF placement were identified. No indications for the prophylactic filter placement reached the threshold. Conclusion: interventional radiologists are highly involved in the management of IVCFs but have limited participation in the development of multidisciplinary clinical practice guidelines.

Highlights

Inferior vena cava filters (IVCFs) are metallic devices designed specially to prevent venous thrombi larger than 3 mm from migrating from the lower extremities to the lung [1].There appear to be no questions about the effectiveness of inferior vena cava filters (IVCFs) even though there is no significant evidence [2]
The placement of IVCF is recommended in the case of VTED with pulmonary embolism (PE)
IVCFs are devices that have been proven to be effective in preventing thrombus migration from the abdomen and lower extremities to the lung

Summary

Introduction

Inferior vena cava filters (IVCFs) are metallic devices designed specially to prevent venous thrombi larger than 3 mm from migrating from the lower extremities to the lung [1].There appear to be no questions about the effectiveness of IVCFs even though there is no significant evidence [2]. There are some unquestionable indications for IVCFs, universally accepted by the scientific community for the prevention of venous thromboembolism (VTE), and these are contraindications to anticoagulant therapy, a hemorrhagic complication of anticoagulant therapy (ACT), and the recurrence of VTE despite correct anticoagulation [3,4]. The indication of an IVCF in recurrent pulmonary embolism (PE) is discussed in some guidelines since it would be necessary to review “the correct anticoagulation therapy” [4,5,6]. In daily practice, IVCFs are used in other clinical indications, such as prophylaxis for VTE high-risk patients, polytraumatized patients, bariatric surgery, and for patients with life-threatening massive pulmonary embolism (PE), that require surgical thrombectomy or catheter-directed treatment (CDT)

Objectives

Methods

Results

Conclusion