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One strategy for managing severe acute venous thromboembolism is placing inferior vena cava (IVC) filters as add-on therapy in patients who are candidates for anticoagulation. Because of the paucity of data on long-term risks and benefits of this approach, guidelines vary.
In this study, nearly 400 patients hospitalized in France with acute symptomatic pulmonary embolism (PE) associated with lower-limb venous thrombosis and ≥1 additional criterion for disease severity were randomized to anticoagulation with retrievable IVC filter implantation or anticoagulation alone. Disease-severity criteria were older age (age, >75), active cancer, chronic cardiac or respiratory disease, recent ischemic stroke with leg paralysis, and right ventricular dys…