Are Prophylactic IVC Filters Effective?

Albert B. Lowenfels, MD


February 06, 2014

The Effectiveness of Prophylactic Inferior Vena Cava Filters in Trauma Patients: A Systematic Review and Meta-analysis

Haut ER, Garcia LJ, Shihab HM, et al
JAMA Surg. 2013 Nov 6. [Epub ahead of print]


Do prophylactic inferior vena cava (IVC) filters benefit trauma patients? To provide information on this controversial topic, the authors reviewed published data and performed a meta-analysis of the available evidence. Evidence from 6 studies showed a significant reduction in pulmonary emboli, and 4 studies showed a reduction in fatal pulmonary emboli. Only a single small randomized trial has been reported with no significant difference in the risk for pulmonary embolus.


The use or non-use of an IVC filter in trauma patients remains a controversial topic. This study points out that many of the studies are small, likely to be biased, and often do not include information about complications of IVC filters. They often lack information to help the clinician decide which patients would or would not benefit from an IVC filter. As the authors suggest, newer removable filters may change the dynamics. Additional studies based on these types of filters will be helpful.