[Vena cava filter. Which indications remain in the era of differentiated anticoagulation?].

CLINICAL/METHODICAL ISSUE: Venous thromboembolism (VTE) is the third most common disease of the cardiovascular system. It is associated with a 30-day lethality in the range of 6  % in deep vein thrombosis and 12  % in pulmonary embolism (PE). There are various guidelines with sometimes controversial recommendations regarding the use of inferior vena cava (IVC) filters. STANDARD RADIOLOGICAL
METHODS: Implantation of IVC filters is a standard therapy in selected patients with an estimated 259,000 filters implanted in 2012. METHODICAL INNOVATIONS: Optionally retrievable filters are increasingly being used in clinical routine practice. Future developments will include biodegradable and drug-eluting filters. PERFORMANCE: When compared to anticoagulation as the reference therapy of VTE, IVC filters will significantly reduce the frequency of symptomatic PE; however, there is no advantage in overall survival for either therapy. ACHIEVEMENTS: Despite different guidelines in clinical routine practice the use of IVC filters appears to depend on the individual clinical experience and assessment of the interventionalist. PRACTICAL RECOMMENDATIONS: Nowadays retrievable filters should be used although there are relevant differences between the various devices. As a matter of principle all IVC filters should be removed as soon as adequate anticoagulation can be established.