Fioretti Agnese Maria, La Forgia Daniele, Scicchitano Pietro, Brunetti Natale Daniele, Inchingolo Riccardo, Tocchetti Carlo Gabriele, Oliva Stefano
Cardio-Oncology Unit, IRCCS Istituto Tumori, "Giovanni Paolo II", 70124 Bari, Italy.
Breast Radiology Department, IRCCS Istituto Tumori, "Giovanni Paolo II", 70124 Bari, Italy.
Biomedicines. 2024 Sep 30;12(10):2230. doi: 10.3390/biomedicines12102230.
Cancer is a remarkable prothrombotic disease, and cancer-associated thrombosis acts as a dreadful omen for poor prognosis. The cornerstone of venous thromboembolism therapy is anticoagulation; however, in patients with venous thromboembolism who are not suitable for anticoagulation (contraindication, failure, or complication), the inferior vena cava filter appears a valuable option in the therapeutic arsenal. The recently heightened trend of steady rise in filter placement mirrors the spread of retrievable devices, together with improvements in physicians' insertion ability, medico-legal issue, and novel and fewer thrombogenic materials. Nevertheless, the exact role of the inferior vena cava filter in cancer has yet to be endorsed due to a dearth of robust evidence. Indeed, data that support the inferior vena cava filter are weak and even controversial, resulting in discrepancies in the interpretation and application of guidelines in daily practice. In this narrative review, we aim at clarifying the state of the art on inferior vena cava filter use in malignancies. Furthermore, we provide a feasible, conclusive 4-step algorithm for the treating physicians in order to offer a practical strategy to successfully employ the inferior vena cava filter as a priceless device in the current armamentarium against cancer.
癌症是一种典型的促血栓形成疾病，癌症相关血栓形成是预后不良的可怕预兆。静脉血栓栓塞治疗的基石是抗凝治疗；然而，对于不适合抗凝治疗（禁忌、无效或出现并发症）的静脉血栓栓塞患者，下腔静脉滤器似乎是治疗手段中的一个有价值的选择。最近滤器置入稳步上升的趋势反映了可回收装置的普及，以及医生置入能力的提高、医疗法律问题以及新型且血栓形成性更低的材料的出现。然而，由于缺乏有力证据，下腔静脉滤器在癌症治疗中的确切作用尚未得到认可。事实上，支持下腔静脉滤器的证据薄弱甚至存在争议，导致在日常实践中指南的解释和应用存在差异。在这篇叙述性综述中，我们旨在阐明恶性肿瘤中下腔静脉滤器使用的现状。此外，我们为治疗医生提供了一个可行的、结论性的四步算法，以便提供一种实用策略，成功地将下腔静脉滤器作为当前抗癌武器库中的一种宝贵装置加以应用。
