PREPIC-1 (Decousus et al. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep vein thrombosis. NEJM 1998; 338:409)
PREPIC-1 Follow-Up Study (Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism. Circulation 2005; 112: 416-422)
PREPIC-2 (Effect of a retrievable inferior vena cava filter plus anticoagulation vs. anticoagulation alone on risk of recurrent pulmonary embolism: A randomized clinical trial. JAMA 2015; 313: 1627)
- For patients receiving anticoagulation, IVC filters do not improve mortality and may increase the risk of DVT and filter-related complications (e.g. filter thrombosis, migration, or fracture).
- It is unclear whether IVC filters reduce the risk of new PE. PREPIC-1 and PREPIC-2 both suggest that there is little or no short-term reduction (e.g. within 6-24 months). Long-term follow-up of the cohort from PREPIC-1 found a reduced risk of new PE at eight years, but this could have been subject to some bias.
- Currently evidence and guidelines from the American College of Chest Physicians both suggest that there is no role for IVC filters among patients who can receive anticoagulation.
Latest posts by Josh Farkas (see all)
- IBCC chapter & cast:Undifferentiated shock - January 17, 2019
- PulmCrit- Vancomycin pharmacokinetics:Make vanco great again - January 16, 2019
- PulmCrit- Acute infection & myocardial infarction:How afraid should we be? - January 14, 2019