Do inferior vena cava filters reduce the risk of acute pulmonary embolism in preoperative patients with venous thromboembolism?

Although prophylactic anticoagulants reduce the risk of acute pulmonary embolism (PE), inferior vena cava filters (IVCF) remain elusive in prophylactic use. This study investigated whether IVCF in addition to anticoagulants augment the prophylactic effect on acute PE in the highest-risk patients. This study included patients with existing venous thromboembolism (VTE) or a history of previous PE, who underwent subsequent surgery for the underlying disease. The hospital records of the patients were reviewed. Forty-nine consecutive patients treated from October 2001 to June 2007 were assessed, including 13 men and 36 women with a mean age of 58.1 years. The underlying diseases that required surgery included malignancy in 23, orthopedic disorder in 14, and others in 12. All patients received anticoagulants, with perioperative IVCF in 31 patients or without in 18. Neither group had any fatal complications. The no-filter group had no cases of recurrent PE, whereas the filter group had one case of recurrent PE just after placement of the filter. Moreover, 5 cases in the filter group had filter-related complications. This study suggested that the addition of IVCF to anticoagulants does not provide a substantial risk reduction for perioperative patients with VTE prior to surgery.