Use of inferior vena cava filters for treatment of VTE: SIR Guideline

Key recommendations include:

Acute PE

• In patients with acute PE with a contraindication to anticoagulation therapy, we suggest an IVC filter be considered based on various clinical risk factors, as outlined in the rationale.

Acute DVT

• In patients with acute DVT without PE and with a contraindication to anticoagulation therapy, we suggest that an IVC filter be considered based on various clinical risk factors, as outlined in the rationale.

Anticoagulation for VTE

• In patients with acute DVT without PE and with a contraindication to anticoagulation therapy, we suggest that an IVC filter be considered based on various clinical risk factors, as outlined in the rationale.
• In patients undergoing extended anticoagulation for VTE (DVT, PE) and have completed the acute phase of treatment in whom a contraindication to anticoagulation develops, we suggest that an IVC filter not be placed, with rare exceptions.

Recurrent VTE

• In patients who are receiving therapeutic anticoagulation for VTE (DVT, PE) who experience a recurrent VTE, we suggest that a filter not be placed, with few exceptions. Reasons for anticoagulation failure should always be addressed.

Routine IVC Filter Placement

• In patients with acute VTE (DVT, PE) who are being treated with therapeutic anticoagulation, we recommend against routine placement of an IVC filter.

PE with Advanced Therapies

• In patients with acute VTE (DVT, PE) who are being treated with therapeutic anticoagulation, we recommend against routine placement of an IVC filter.