More than 300,000 Americans die from acute pulmonary embolism each year. Pulmonary embolism, treated with blood thinners or a filter, occurs when a blood clot travels to the lungs and causes a fatal blockage.
Blood clot filters are implanted in the inferior vena cava (IVC) and used for the prevention of pulmonary embolism. A recent analysis of national data, published in the National Library of Medicine, shows that blood clot filters may come with serious side effects.
Are Blood Clot Filters On The Rise?
IVC filters were introduced in the 1960s and approved by the Food and Drug Administration (FDA) through the agency’s 501(k) expedited process. As the population ages, blood clot filters placement has increased as an alternative to anticoagulant medications. Trends illustrate more patients receive temporary, rather than permanent, IVC filters.
National data from Medicare and a National Discharge Survey indicates blood clot filter placement has markedly increased in the last two decades.
Data shows the placement of inferior vena cava (IVC) filters have been expanding, despite a lack of clear directing evidence. When IVC filters were approved, there was minimal data about blood clot filters, along with inconsistent recommendations across societies about how blood clot filters should be used.
Study Data On Blood Clot Filters
Researchers examined how well blood clot filters work, measuring complication rates and national trends. The study data comes from a 9-year period at Einstein Medical Center in Philadelphia, PA. The researchers also assessed national trends using the Nationwide Inpatient Sample.
The patients had an IVC filter implanted between 2003 and 2013. They were likely to elderly and high-risk for bleeding complications when using blood thinners.
Though temporary filters are becoming increasingly popular, the researchers found that only 7 percent of filters designed for retrieval were successfully removed. Researchers discovered many patients qualified for filter removal after receiving an IVC filter, but hospitals discharged patients with the device still in place. They suspect the reasoning could be “an increased reimbursement rates when filters are retrieved in an outpatient setting and an under-appreciation of the potential harms of leaving filters in place for extended periods.”
Although temporary IVCFs are becoming increasingly popular, their timely removal remains a significant challenge.
In 2010, the FDA issued a safety warning to inform physicians to remove IVC filters as soon as the risk of pulmonary embolism had subsided. The filters, though minimally invasive, have been associated with”clear evidence for filter-related complications even several years after placement.”
Some patients may experience complications early on, while others develop no symptoms. Potential complications, though varied, include:
- Access site hematoma
- IVC thrombosis
- IVC perforation
- Air embolism
- Filter migration
- Filter fracture
More temporary IVC filters are placed for prior falls and bleeding complications. In order to avoid exposing patients to unnecessary risks with little benefits, researchers acknowledge that filters should be removed as soon as possible.
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