Purpose: The authors examined the appropriateness and outcome of inferior vena caval (IVC) filter placements in patients with advanced malignancies and limited expected survival.
Patients and methods: Over a 35-month period, 35 IVC filters were inserted in 34 adult patients with advanced neoplasms. Follow-up was as long as 28 months (mean, 5.2 months). Filter effectiveness, complications, recurrent pulmonary emboli, patient survival, and hospital discharge status were recorded.
Results: Twenty-eight patients (82%) were discharged home (n = 21) or to nursing facilities (n = 7) between 1 and 193 days (mean, 23 days) after filter insertion. Six patient (18%) died during hospitalization 1-95 days after filter insertion. The overall mean survival was 6.6 months; for patients with stage III and IV tumors mean survival was 8.0 and 5.5 months, respectively. Even among patients with stage IV disease, 59% survived longer than 3 months. There were no complications related to filter insertion and no clinical evidence of recurrent pulmonary emboli. In 14% of patients, filters enabled invasive therapeutic and palliative procedures to be performed.
Conclusion: The presence of advanced neoplastic disease by itself should not be a deterrent to insertion of IVC filters, as most patients survived well beyond initial hospitalization.