We Can Protect the Patient with an Inferior Vena Cava Filter

The scant available evidence for the efficacy and safety of IVC filters best support use when anticoagulation is contraindicated in a patient at high risk for PE or when adequate anticoagulation therapy has failed. With HIT, anticoagulation with an alternative agent is strongly indicated, not contraindicated. My colleagues and I have seen half a dozen patients in whom an IVC filter was placed in the extreme hypercoagulable situation of acute HIT, who promptly clotted the filter and developed venous limb gangrene (Rice L, Baker KR, McCarthy JJ, unpublished observations).

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