Clinical Takeaway: Retrievable inferior vena cava filters are appropriate in patients with pulmonary embolism or deep venous thrombosis and contraindications to anticoagulation. However, IVC filters are not benign, and mounting evidence suggests their complication rate may be higher than previously recognized. These risks likely go up the longer IVC filters are left in place. Most patients' contraindication to anticoagulation is temporary, and anticoagulation should be given after an IVC filter is in place as soon as possible in most patients. Retrievable IVC filters should be removed as soon as it is reasonable to do so (in many patients, this can be 2-3 weeks after anticoagulation is begun). Prophylactic placement of IVC filters in patients at risk of DVT is common, though controversial; these patients in particular should have their IVC filters removed as soon as possible, to avoid preventable complications.
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