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Prophylactic implantation of inferior vena cava filter during endovascular therapies for deep venous thrombosis of the lower extremity: is it necessary?

Background: There is strong controversy as to whether to use filters temporarily in the inferior vena cava (IVC) during endovascular therapies for deep venous thrombosis (DVT) in the lower extremity. Purpose: To evaluate the necessity of implantation of a retrievable inferior vena cava filter during treatment of DVT in the lower extremity using various endovascular techniques. Material and Methods: Studied were all 37 consecutive sessions of endovascular treatments performed in 34 patients with symptomatic lower-limb DVT between April 2001 and October 2006. In all sessions, a Gunther tulip retrievable vena cava filter (GTF) was implanted during the procedures. The degree of trapped thrombus in the filter was evaluated by repeated venocavography. Results: Implantation of a total of 66 GTFs was successfully performed in 37 sessions. Worsening of or new formation of pulmonary embolism was avoided in all patients. In 20 (54.1%) of the 37 sessions, a trapped thrombus in the filter was observed. In 14, the trapped thrombus was large, filling more than half the height of the filter. Conclusion: Temporary implantation of filters is effective in preventing pulmonary emboli during endovascular treatment of DVT in the lower extremities.