Outcomes of Inferior Vena Cava Filter Placement during Pharmacomechanical Thrombectomy for Iliofemoral Vein Thrombosis
10.37923/phle.2025.23.2.101
- Author:
Myeonghyeon KO
1
;
Kyong Hye JOUNG
;
Song-Yi KIM
Author Information
1. Department of Surgery, Chungnam National University Sejong Hospital, Sejong, Korea
- Publication Type:Original Article
- From:
Annals of phlebology
2025;23(2):101-107
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:The efficacy of routine inferior vena cava (IVC) filter placement during catheterdirected thrombolysis (CDT) or pharmacomechanical thrombectomy (PMT) for iliofemoral deep vein thrombosis (IF-DVT) remains controversial. This study aimed to evaluate whether routine IVC filter placement improves prevention of pulmonary thromboembolism (PTE) or recurrent venous thromboembolism (VTE) in this population.
Methods:We retrospectively reviewed adults with acute IF-DVT treated with CDT/PMT (March 2021–February 2025) and compared outcomes between a filter group (n=17) and no-filter group (n=21). All patients received six months of oral anticoagulation. The primary outcome was incident PTE within six months. Secondary endpoints included the 6-month composite of recurrent VTE (recurrent deep vein thrombosis and/or PTE), inferior vena cava thrombosis, and target-limb stent occlusion.
Results:Baseline limb laterality, thrombus extent, and concomitant PTE were similar. Primary outcome: PTE at six months—0/17 (0%) in the filter group vs 1/21 (4.8%) in the nofilter group (p>0.999). Secondary outcomes: recurrent DVT—3/17 (18%) vs 1/21 (4.8%) (p=0.307); IVC thrombosis—1/17 (5.9%) vs 0/21 (0%) (p=0.447); stent occlusion—1/17 (5.9%) vs 2/21 (9.5%) (p>0.999). Event-free survival also did not differ (log-rank p=0.43).Beyond six months, long-term composite events were infrequent with no significant differences.
Conclusion:In anticoagulated patients undergoing CDT/PMT for acute IF-DVT, routine prophylactic IVC filter placement did not improve short- or long-term outcomes, including prevention of PTE. These data support a selective, rapid-retrieval strategy for highembolic-risk scenarios.
