January 23, 2017 — Hospitals that implant “temporary” IVC filters should plan on removing them from patients, according to new recommendations from health officials in Australia.
The Australian Therapeutic Goods Administration (TGA) issued a Medical Device Safety Update for IVC filters, along with “Top Health Hazards for 2017.”
IVC filters are umbrella-shaped devices that are implanted in a major vein called the inferior vena cava (IVC). The needle-like wire legs, called “struts,” are designed to catch blood clots traveling in the bloodstream to prevent life-threatening pulmonary embolisms.
The TGA warns that IVC filter implantation has become commonplace “despite the lack of good quality evidence supporting their use.” The agency is concerned that short-term filters are not routinely removed.
“We encourage each health facility to identify all patients who have a retrievable IVC filter placed and to develop a formal strategy to assess these patients for filter removal to reduce the known risks.”
Known complications include migration, vein perforation, fracture of the filters’ struts, embolization of broken pieces of the filter, and death.
There have been no reports of death in Australia, but deaths have been reported in other countries. The TGA has received 21 reports of IVC filter injuries in the 10 years before November 2016, with 76% of those reported as causing a serious injury to the patient.
There have been 7 recalls for IVC filters in Australia, according to the TGA. Some recalls were issued due to movement of the filter.
In the United States, the FDA has recommended removing IVC filters within 29-54 days, or as soon as a patient’s short-term risk of blood clots subsides.
Warnings are stronger in Canada, where officials recommend that hospitals identify patients who have received temporary IVC filters and follow-up for removal.
Health Canada also says IVC filters should only be implanted in patients who cannot take blood-thinning medications — and only if they have also been diagnosed with blood clots, Deep Vein Thrombosis (DVT), or a Pulmonary Embolism (PE).
Guidelines in the U.S. are far more relaxed, with many hospitals routinely implanting IVC filters in patients who are at risk of developing blood clots — even if they do not have any blood clots yet, or if they can take a blood-thinning medication instead.
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