Unfortunately, there is a lack of studies evaluating the use of IVCFs specifically in cancer patients.3 Most of the studies available are not head-to-head comparisons and rarely include the gold standard use of low molecular weight heparin.3
Therefore it is extremely difficult to compare the use of IVCF and therapeutic ATC in patients with cancer, especially with respect to efficacy.
As with any procedure, there are risks associated with the placement of an IVCF. Complications include bleeding at entry site, air embolism, nerve impingement, filter fracture, recurrent VTE, filter migration, venous perforation, and IVCF thrombosis.1,5
A study conducted by Abtahian and colleagues2 evaluated the IVCF-associated complications specifically in patients with cancer and did not find a significantly increased complication risk when compared to patients without cancer.
In this study, 17.7% of patients with cancer experienced a complication compared with 19.8% of patients without cancer, which was not statistically significant.2
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However one difference that was identified was when a retrievable IVCF was placed there was a statistically significantly lower rate of retrieval in patients with cancer (28%) compared with patients without cancer (42%).2
If a patient with cancer receives a potentially retrievable IVCF, the role of full dose ATC should be periodically re-evaluated as the patient’s clinical scenario may change over time.
In certain scenarios, the patient may eventually become eligible for full dose ATC at which point the IVCF should be removed.
- Ryu RK, Lewandowski RJ. Optimizing the use of inferior vena cava filters in oncology patients: are all filters created equally? Semin Thromb Hemost. 2014;40(3):401-416.
- Abtahian F, Hawkins BM, Ryan DP, et al. Inferior vena cava filter usage, complications, and retrieval rate in cancer patients. Am J Med. 2014;127(11):1111-1117.
- Farge D, Debourdeau P, Beckers M, et al. International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer. J Thromb Haemost. 2013;11(1):56-70.
- Imberti D, Agnelli G, Ageno W, et al. Clinical characteristics and management of cancer-associated acute venous thromboembolism: findings from the MASTER Registry. Haematologica. 2008;93(2):273-278.
- Ingber S, Geerts WH. Vena caval filters: current knowledge, uncertainties and practical approaches. Curr Opin Hematol. 2009;16(5):402-406.