Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, AL.
Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, AL.
Semin Vasc Surg. 2024 Jun;37(2):164-178. doi: 10.1053/j.semvascsurg.2024.04.002. Epub 2024 Apr 30.
Concern regarding the exponential increase in optional utilization of inferior vena cava filters (IVCFs) in the early 2000s with a persistent low retrieval rate nationwide has resulted in increased scrutiny regarding clinical application of IVCFs. IVCFs are used in a variety of clinical scenarios, ranging from thromboembolic protection in patients with deep venous thrombosis and contraindication to anticoagulation to prophylactic deployment in multitrauma and critically ill patients. Evidence supporting IVCFs as mechanical thromboembolic protection in certain clinical scenarios has been established through evidenced-based guidelines. As an adjunct to evidence-based guidelines, appropriateness criteria to address specific clinical scenarios and facilitate clinical decision making when considering placement of an IVCF have been developed. In this review, current evidence-based and appropriateness guidelines are summarized.
人们对 21 世纪初下腔静脉滤器（IVCF）的非强制性使用呈指数级增长且全国范围内的回收率持续偏低表示担忧，这导致了对 IVCF 临床应用的审查更加严格。IVCF 可用于多种临床情况，从深静脉血栓形成患者的血栓栓塞保护到抗凝禁忌，再到多发创伤和重症患者的预防性放置。通过循证指南，已经确定了在某些临床情况下使用 IVCF 作为机械性血栓栓塞保护的证据。作为循证指南的辅助手段，已经制定了适当性标准，以解决特定的临床情况，并在考虑放置 IVCF 时为临床决策提供便利。在这篇综述中，总结了当前基于循证和适当性的指南。
