Vena Cava Filters: Continuing the Search for an Ideal Device

Abstract

IN 1989, an article was published titled “Inferior Vena Cava Filter: Search for an Ideal Device” (1). In that article, Yune outlined many of the requirements for an ideal filter, including the ability to retrieve the device, and pointed out the need for prospective, randomized, multicenter clinical studies. Since then, more than 16 years have passed. What progress has been made? Unfortunately, in the arena of prospective trials, we have largely failed: as Girard and colleagues (2) point out, the literature regarding filters continues to be weak, and “many if not most indications for filter placement will remain a matter of opinion.” We have seen successes and failures with device design, but some progress has been made, and three retrievable or optionally retrievable filters are now approved by the Food and Drug Administration: the Recovery filter (RF) (CR Bard, Tempe, AZ), the Gunther Tulip filter (GTF) (Cook, Bloomington, IN), and the OptEase filter (OF) (Cordis, Miami, FL). In this issue of JVIR, Oliva et al (3) provide us with data on a series of 27 patients treated with the OF. This adds to the existing literature regarding this device, which includes a series of 94 trauma patients treated with the OF (4).