Inferior vena cava interruption: How and when?

interruption of the inferior vena cava (IVC) to prevent pulmonary embolism arising from venous thrombi in the lower extremities has become widely used since IVC filters became available about 30 years ago. However, reliable d ata regarding efficacy and safety of IVC filters are still lacking. The fir st controlled clinical trial of IVC filters demonstrated their effectivenes s, but filters had no detectable impact on mortality and were associated wi th an increased risk of recurrent deep venous thrombosis. On the basis of t he literature, indications for IVC interruption can be classified as accept ed, debated, and debatable. The relevance of debated indications, more accu rate identification of patients who remain "very high-risk" despite prevent ive or curative anticoagulant treatment, and selection of the most appropri ate filter should be looked at in prospective clinical studies.