The use of retrievable inferior vena cava, or IVC, filters has fallen since the U.S. Food and Drug Administration (FDA) issued a safety warning in 2010 about fracture and other adverse effects linked to the devices, but the rate for implanting the devices remains high, according to findings from a study announced earlier this summer by Temple University Hospital (TUH) researchers. The findings lead some medical experts to fear that retrievable IVC filters are being overused – exposing more people to a higher risk of complications associated with the devices, without a known significant benefit, the Cardiovascular Research Foundation reports.
The TUH research team was led by Riyaz Bashir, MD, FACC, RVT, Director of Vascular and Endovascular Medicine at TUH. The team examined the rates of retrievable IVC filter placement in the U.S. from January 2005 to December 2014, which was compiled by the National Inpatient Sample database.
During the 10-year period, more than 1.13 million patients received an IVC filter implant. There was an initial surge in IVC filter placement between 2005 to 2010, but following the FDA safety warning in 2010 filter placements dropped by 29 percent. However, the rate for IVC filter use is still significantly higher in the U.S. (39.1 per 100,000 people) than in five large European countries (3 per 100,000 people). Despite the drop-off in IVC filter usage, the rate of hospitalization for venous thromboembolism remained steady.
The cage-like device is implanted in the inferior vena cava to catch blood clots that form in the legs and keep them from reaching the heart, lungs and other vital organs, as discussed previously by Beasley Allen. Retrievable IVC filters are used as an alternative to help prevent venous thromboembolism, such as deep vein thrombosis or pulmonary embolism, in trauma patients when they are unable to take blood thinners.
Retrievable filters are more prone to fracture, migrate or tilt within the body than their predecessor, the permanent IVC filter, because of their more fragile design. These adverse events can cause life-threatening injuries, which is the reason thousands of patients have filed lawsuits nationwide against various IVC filter manufactures.
Currently, cases involving Cordis IVC filters are consolidated in California state court while a multidistrict litigation (MDL) has combined approximately 2,213 claims against C.R. Bard, Inc. that is pending in U.S. District Court in Arizona, according to the Judicial Panel on Multidistrict Litigation. Another MDL has centralized 2,342 claims against Cook Medical in the in the U.S. District Court for the Southern District for Indiana. The first bellwether trial for the Cook Medical MDL is slated to begin Oct. 2.
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Temple University Hospital
Cardiovascular Research Foundation
Judicial Panel on Multidistrict Litigation