Medical researchers are advising against the routine use of IVC filters in trauma patients, following an investigation which found that the devices offer little in the way of benefits. Their findings, which were published in JAMA Surgery, indicated trauma patients who had received the blood clot filters had no survival advantage compared to those who did not.
The research looked at 451 IVC filter recipients and 1,343 controls, all of whom underwent trauma care at Boston Medical Center. Filter use was not associated with any decrease in death rates among patients who survived at least 24 hours after their injury, even if they were at risk for deep vein thrombosis or pulmonary embolism. Similar observations were made at 6-months and 1-year post injury.
“Overall, these data indicate that IVC filters should not be placed in trauma patients in an effort to decrease all-cause mortality,” the research team concluded.
The authors of the study also noted that during its 3.8-year follow up period, just 8% of the IVC filters were removed. Other research has suggested that un-retrieved filers may cause a number of potentially-deadly complications, including IVC filter fracture, filter thrombosis, filter protrusion outside the IVC, and lower-extremity venous thrombosis.
“Risk of morbidity should be considered before placing an IVC filter, especially in younger trauma patients because complications are known to increase with time,” they wrote. Retrievable filters that are not removed carry a higher risk profile than the previously used permanent filters, and many retrievable IVC filters are not removed when the initial indication for placement resolves.”
IVC filters are small, cage-like implants that are inserted into the inferior vena cava, where they intercept blood clots before they can travel to the heart and lungs. In 2010, the U.S. Food & Drug Administration disclosed that its adverse event database had received more than 900 reports of IVC filter complications linked to retrievable devices, which are intended to be removed once the recipient is no longer at risk for blood clots. Four years later, the agency issued a second advisory that urged doctors to remove temporary blood clot filters within 29 to 54 days of their implantation in order to reduce the risk of patient harm.
Court documents indicate that more than 1,600 IVC filter lawsuits have been filed in U.S. courts on behalf individuals who allegedly suffered severe injuries related to retrievable devices manufactured by C.R. Bard, Inc. and Cook Medical, Inc. Plaintiffs involved in these cases claim that the companies’ retrievable filters are prone to fracture, migration and other problems that can result in life-threatening complications.