Review of indications and practices of vena caval filters at a large university hospital

Background: Vena caval filter (VCF) use has been increasing in recent years. Prophylactic VCF placement has been applied liberally in high-risk patients. Methods: Consecutive patients with VCF placement over a 2-year period at a university hospital were reviewed. Results: A total of 244 patients underwent VCF placement in 2 years. Of all, 54% of the patients had the VCF placed for an absolute indication, 14% for a relative indication, and 32% for prophylaxis. Only 14 (9%) of the retrievable filters were removed. Eight patients had a complication of VCF placement; there were no complications of filter retrieval. Vena caval filter placement for prophylaxis alone was 57% from the division of trauma and surgical critical care, 18.3% from interventional radiology department, and 5.2% from the division of vascular surgery. Conclusions: This study indicates that many VCFs are placed for prophylaxis. A low percentage of VCFs was retrieved. This may be the practice at many other large university-based hospitals, necessitating strategies for reducing their placement.