Implications and limitations of the PREPIC2 study—the interventionist’s perspective

Inferior vena cava (IVC) filters have proven invaluable in the prevention algorithm for pulmonary embolism (PE), reflected in their increased use within the past decade (1). On the other hand, prolonged dwell time, overall low retrieval rates ranging from 1.0−40.5%, and lack of follow-up, have resulted in an increase incidence of filter-related adverse events (2). Permanent and retrievable filters are available Expanding indications, and specifically prophylactic placement in patients with high risk of venous thromboembolic disease, have contributed to steady rise in retrievable IVC filter placements, without clear support of clinical consensus guidelines (3). The estimated amount of implanted IVC filters were 2,000 in 1979 and increased by a factor of approximately 83.5 in 2007 to almost 167,000 (1). Though there is lack of evidence based on randomized trials for the efficacy of IVC filters to positively impact patient outcome.