Background: Inferior vena cava filters (IVCF) are often used to prevent pulmonary thromboembolism (PTE). The present study assessed how to maximize the ability of IVCF to prevent PTE. Methods and results: Data from 74 patients (35 men, 29 women; mean age, 57.6 years) who had been fitted with an IVCF at our institution between 2001 and 2012 were retrospectively analyzed. Indications for deployment comprised a diagnosis of pulmonary embolism or deep venous thrombosis (DVT) with a contraindication to anticoagulation (n=2), prophylactic filter placement for high-risk surgical patients (n=10) and high risk for either PTE (n=9) or DVT (n=73). Permanent (Greenfield filter [GF], n=7; Günther Tulip Filter [GTF], n=34) and temporary (temporary type, n=18; GTF, n=15) filters were deployed in 41 and 34 of the 74 patients, respectively. Thirteen (86.7%) of the 15 temporary GTF filters were retrieved, and 43 (93.5%) of 46 patients in whom filters were permanently deployed (GF, n=8; GTF, n=38) were also administered with warfarin. Pulmonary thromboembolism did not recur or arise during a mean follow-up period of 27 months. Thirteen of these 46 patients were assessed by enhanced computed tomography during follow-up at the chronic stage. The legs of the filter had penetrated the IVC wall by over 3 mm in 5 (38.5%) patients, but neither leakage from the IVC nor damage to adjacent organs was evident. Other complications included retroperitoneal bleeding (n=1), intrapleural bleeding (n=1), and an IVC thrombotic episode (n=1). Conclusion: Inferior vena cava filters prevented PTE, but filters deployed for permanent IVCF require mandatory careful observation due to a tendency to penetrate the IVC wall.

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