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Clinical Investigations: PULMONARY EMBOLISM |

Medical Literature and Vena Cava Filters*: So Far So Weak

Philippe Girard, MD, FCCP; Jean-Baptiste Stern, MD; Florence Parent, MD
Author and Funding Information

*From the Département thoracique (Drs. Girard and Stern), Institut Mutualiste Montsouris, Paris; and the Service de pneumologie et réanimation (Dr. Parent), Hôpital Antoine Béclère, Clamart, France.

Correspondence to: Philippe Girard, MD, FCCP, Département thoracique, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France; e-mail: philippe.girard@imm.fr



Chest. 2002;122(3):963-967. doi:10.1378/chest.122.3.963
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Study objective: With the development of percutaneous inferior vena cava (IVC) filters, IVC interruption has become a widely used procedure in patients with or at risk for venous thromboembolism. In an attempt at clarifying the indications for filter placement, a systematic literature review was undertaken.

Design: Bibliographic search and analysis.

Measurements and results: A systematic MEDLINE search about vena cava filters produced a total of 568 references with abstracts between 1975 and 2000 inclusively. Each reference was analyzed according to predetermined criteria. Nearly two thirds (65.0%) of these publications were retrospective studies or case reports (33.3 and 31.7%, respectively), 12.9% were animal or in vitro studies, 7.4% were prospective studies, 6.7% were reviews, and 8.1% reported on miscellaneous related topics. Among the prospective studies, only 16 studies included ≥ 100 patients, only 1 study was a randomized controlled trial (0.02% of 568 references), and heterogeneity among series precluded any relevant comparison. In a similar search about heparin and venous thromboembolism, 47.4% of 531 references were randomized controlled trials.

Conclusions: Until more relevant data become available, literature reviews about vena cava filters will remain narrative, and many if not most indications for filter placement will remain a matter of opinion.

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