Rajasekhar Anita
University of Florida College of Medicine, Health Science Center, PO Box 100278, Gainesville, FL, 32610, USA,
J Thromb Thrombolysis. 2015 Apr;39(3):315-27. doi: 10.1007/s11239-015-1187-5.
Venous thromboembolism (VTE) is a common cause of inpatient and outpatient morbidity and mortality. While anticoagulant therapy is considered the primary means of prevention and treatment of VTE, inferior vena cava filters (IVCFs) are often used as an alternative or adjunct to anticoagulation. With the advent of retrievable filters indications have liberalized, to include placement for primary prophylaxis in high-risk patients. However, this practice is based on limited evidence supporting their efficacy in preventing clinically relevant outcomes. Since indiscriminate use of IVCFs can be associated with net patient harm and increased health care costs, knowledge of the literature surrounding IVCF utilization is critical for providers to adopt best practices. In this review, we will provide an overview of the literature as it relates to specific clinical questions that arise when considering IVCF utilization in the prevention and treatment of VTE. Practice-based recommendations will be reviewed to provide the clinician with guidance on challenging clinical scenarios.
静脉血栓栓塞症（VTE）是住院患者和门诊患者发病和死亡的常见原因。虽然抗凝治疗被认为是预防和治疗VTE的主要手段，但下腔静脉滤器（IVCF）常被用作抗凝的替代或辅助手段。随着可回收滤器的出现，其适应证有所放宽，包括用于高危患者的一级预防。然而，这种做法基于有限的证据支持其在预防临床相关结局方面的疗效。由于IVCF的滥用可能会给患者带来净伤害并增加医疗成本，了解IVCF使用相关的文献对于医疗服务提供者采用最佳实践至关重要。在本综述中，我们将概述与在考虑使用IVCF预防和治疗VTE时出现的特定临床问题相关的文献。将回顾基于实践的建议，为临床医生在具有挑战性的临床场景中提供指导。
