Indications for IVC filter placement.

Placement of an IVC filter is indicated for patients who develop recurrent DVT (significant propagation of the original thrombus or proximal DVT at a new site) or pulmonary embolism (PE) despite adequate anticoagulation therapy and for patients with pulmonary hypertension who experience recurrent PE.

In patients who receive IVC filters for these indications, therapeutic anticoagulation should be continued.

The duration of anticoagulation is determined by the underlying venous thromboembolism (VTE) and not by the presence of the IVC filter itself.

Practically speaking, however, many patients who require an IVC filter for recurrent VTE are the same ones who would benefit most from indefinite anticoagulation.

The other major indication for placement of an IVC filter is a contraindication to, or complication of, anticoagulation therapy in the presence of an acute proximal DVT.