patients with blood clots in the veins of their legs — a
debilitating condition called deep-vein thrombosis —
physicians sometimes implant miniature filters to prevent the
clots from migrating to the lungs.
devices can break and perforate blood vessels, and there is
little evidence they save lives, leading some medical
societies to conclude they are not worth the risk.
there is some question whether the clot-trapping filters might
be a sound approach for a subset of patients who undergo an
additional procedure, in which physicians use a catheter to
deliver clot-busting drugs directly to a clot in the legs.
answer, according to a new study led by a Temple University
cardiologist, is still no.
group of more than 7,000 patients who underwent the catheter
procedure, those who also had a filter implanted were no more
likely to survive their hospital visit than those who did not
get a filter, the authors reported in the journal JACC
more, patients who received the filters were more likely to
suffer a hematoma — an abnormal mass of partly clotted
blood. And they stayed in the hospital longer, running up a
bigger bill. Average hospital charges were $104,000 for those
who got the filters vs. $93,000 for those who did not.
filters are small, basket-like devices made of wire, placed in
a vein in the abdomen called the inferior vena cava.
general, physicians should avoid using the devices in patients
with deep-vein thrombosis, unless they cannot tolerate the
standard treatment with blood-thinning medicines, said senior
author Riyaz Bashir, a professor at Temple’s Katz School of
somebody is able to take blood-thinning medicine, there is no
reason to put a filter in," said Bashir, director of
vascular and endovascular medicine at Temple University
limitation of the study was that patients were not randomly
chosen to receive a filter, meaning that authors could not
rule out other factors that might determine how well the
devices functioned. Still, the research suggests that the
filters are inappropriate in most cases, according to McMaster
University physicians Mark Crowther and Andrea Cervi, who
wrote an editorial that accompanied the study.
authors are to be congratulated on this study, which provides
a sobering counterpoint to the high frequency of IVC filter
use," Crowther and Cervi wrote.
thrombosis leads to 600,000 hospital visits a year in the
United States. When a clot breaks loose and travels to the
lungs, it is called a pulmonary embolism — a dangerous
condition that was blamed in the December 2017 death of Jordan
Feldstein, manager of the group Maroon 5.
of deep-vein thrombosis can include aching, throbbing, and
swelling in the legs. It is more common in older people,
though Feldstein was just 40. Other risk factors include
obesity and cigarette smoking.