Dr. Anita Rajasekhar and Dr. Joseph Stavas both agreed that the data does not support many cases when IVC filters are being used. For example, IVC filters are often placed in patients who have a potentially high risk of deep vein thrombosis (DVT) but no known clot (i.e., bariatric surgery or hip replacement patients).
Both doctors also expressed concern about a lack of studies that temporary IVC filters lower mortality, with Dr. Stavas agreeing that “the evidence is all over the chart.” Only two randomized controlled trials have evaluated their efficacy in the last 40 years, but neither showed any survival advantage with IVC filters.
Numerous studies have also shown that IVC filters can increase the risk of developing blood clots in the long-term, especially in the lower extremities or below the filters.
Despite growing evidence of long-term safety risks and a lack of consensus about when they should be used, the use of IVC filters has skyrocketed in the last 10 years. Dr. Stavas called for improved guidelines and design changes, warning that they were overhyped in the 1970s and “eventually became a crutch … providing a false sense of security.”
Dr. Rajasekhar said there were certainly situations in which IVC filters should be used, such as patients with acute DVT who need to undergo surgery and therefore cannot take a blood-thinning drug. However, outside of this very specific patient population, “clearly, the risks outweigh the benefits.” She called it “inexplicable” that the filters would be used in high-risk cancer patients who are already at significantly increased risk of blood clots.
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