Vena Cava Retrievable Filters No Help in Pulmonary Embolism
No difference in recurrent pulmonary embolism for filter plus anticoagulation, anticoagulation alone
WEDNESDAY, April 29, 2015 (HealthDay News) -- For patients with acute, symptomatic pulmonary embolism, the use of retrievable vena cava filters with anticoagulation does not offer any benefit over anticoagulation alone, according to a study published online April 28 in the Journal of the American Medical Association.
Patrick Mismetti, M.D., Ph.D., from the Universitaire de Saint-Etienne in France, and colleagues conducted a randomized trial with six month follow-up to examine the efficacy and safety of retrievable vena cava filters plus anticoagulation versus anticoagulation alone for preventing pulmonary embolism recurrence. Hospitalized patients with acute, symptomatic pulmonary embolism associated with lower-limb vein thrombosis who met at least one criterion for severity were randomized to retrievable inferior vena cava filter implantation plus anticoagulation (filter group, 200 patients) or anticoagulation alone (control group, 199 patients).
The researchers found that the filter was successfully implanted in 193 patients from the filter group and was retrieved as planned in 153 of 164 patients. Recurrent pulmonary embolism occurred in six patients (3.0 percent) in the filter group and in three patients (1.5 percent) of the control group by three months (relative risk with filter, 2.00; 95 percent confidence interval, 0.51 to 7.89; P = 0.50). Similar results were seen at six months. Other outcomes did not differ between the groups.
"These findings do not support the use of this type of filter in patients who can be treated with anticoagulation," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.