Evidence Base for Vena Cava Filter Use 'Thin'

Cheryl Clark, April 11, 2013

Doctors are placing controversial 'retrievable' vena cava filters to prevent blood clots in thousands of patients, but many of these devices are placed inappropriately, without the needed evidence that they even work.

And for most of these patients, the filters were left in too long, or never taken out, with some patients getting harmed in the aftermath, for example when the filters migrated or fractured inside the body.

Moreover, the inordinate use of these inferior vena cava (IVC) filters without indication "may be influenced by inpatient hospital reimbursement," for example, payment from Medicare "increases by almost 250% if an IVC filter is placed."

Those are conclusions from a retrospective review of IVC filter use in 952 patients treated at Boston Medical Center between Aug. 1, 2003 and Feb. 28, 2011, according to the authors, hematologist/oncologist J. Mark Sloan MD, and colleagues at BMC.

Use of these filters, about two-inches in size, has steadily climbed, form 2,000 in 1979 to 50,000 in 2010.


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