Prophylactic Caval Insertion In Patients With Malignancy

Patients with malignancies have hypercoagulable states and experience frequent thromboembolic events.25,38 Some studies suggest that despite adequate anticoagulation, throm-boembolism can occur in such patients to a greater degree than other patients. The associated comorbidities of patients with malignancies undergoing cancer therapy frequently places them at greater risk for bleeding complications from anticoagulation. The use of caval filters in these patients has been applied with conflicting results. In a recent report, the American College of Chest Physicians Consensus Committee on PE discouraged the routine use of IVC filters in cancer-associated DVT/PE and recommended the use of anticoagulation therapy until a randomized controlled study comparing the two modalities becomes available.19 The use of filters has also been criticized in these patients due to the high cost and high mortality rate experience in these patients in many IVC filter studies.25

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