Despite complications linked to inferior vena cava (IVC) filters, the IVC filter market appears to be expanding.
A 2014 study published in the Journal of Vascular Surgery — Venous and Lymphatic Disorders found that the number of IVC filters placed in patients in the U.S. increased by 234 percent between 2000 and 2009.
Designed to filter blood clots that travel from the lower body to the heart and lungs, IVC filters are surgically implanted within the vena cava, the two large veins on the right side of the body, that return deoxygenated blood from the body into the heart. The inferior vena cava is the body’s largest vein.
IVC filters are an alternative for patients who are unable to use an anticoagulant to prevent a pulmonary embolism, which is what happens when a blood clot reaches the lungs.
Each year between 400,000 and 650,000 people in the United States develop a pulmonary embolism, with 50,000 to 240,000 of those being fatal.
An IVC filter — which can be either a permanent or temporary fix — is used to prevent thromboembolic events, which occur when a blood clot breaks loose and travels through the blood stream and plugs another vessel. If the blood clot plugs the lungs, a pulmonary embolism occurs. A person suffers a stroke if a blood clot plugs the brain.
A June 2017 study of retrievable IVC filters — published in the American Heart Association’s online journal Circulation: Cardiovascular Interventions — found that the longer the devices remained in the body, the greater the health risk for the patient.
The results of the study of 762 patients who underwent IVC filter retrieval procedures found that after seven months, the risk of failure when using the standard retrieval technique was just shy of 41 percent.
But when the filter was in the body fewer than seven months, there was an 82 percent retrieval success rate.
While there has been much discussion in the medical community about complications related to the devices, the United States’ IVC filter market is forecast to see “outstanding growth” until 2022, reports website MedGadget.com.
And in April 2017, leading technology research firm Technavio predicted that the global IVC filter market will see steady growth over the next four years and post a compound annual growth rate of more than 11 percent by 2021.
According to the Technavio report, the IVC filter market growth can be attributed to an increasing incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) and market research that shows a preference for minimally invasive procedures, which IVC filter implantation is considered to be.
A 2006 article by Dr. Thuong Van Ha, director of Clinical Research Vascular & Interventional Radiology at the University of Chicago, noted the three categories of IVC filter complications:
- Procedural complications, including those related to both venous access and filter deployment;
- Delayed complications, including filter fracture, migration, IVC thrombosis, and recurrent PE;
- And complications of filter retrieval after implantation of temporary IVC filters.
The U.S. Food and Drug Administration in 2010 acknowledged side effects, including lower limb deep vein thrombosis (DVT), filter fracture, filter migration, filter embolization and IVC perforation, in patients who did not have their retrievable IVC filters removed once the risk of pulmonary embolism subsided.
In 2014, the agency issued a safety communication, recommending that implanting doctors caring for patients with retrievable IVC filters consider removing the filter as soon as protection from pulmonary embolism is no longer needed.
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