Which of the following is an accepted primary indication for placement of an inferior vena cava (IVC) filter?
- A First episode of deep vein thrombosis in a patient tolerating warfarin
- B Recurrent superficial thrombophlebitis despite compression stockings
- C Documented pulmonary embolism or proximal DVT with an absolute contraindication to anticoagulation ✓
- D Routine prophylaxis in all patients undergoing hip replacement surgery
Correct answer: C. Documented pulmonary embolism or proximal DVT with an absolute contraindication to anticoagulation
Explanation
An IVC filter is indicated when venous thromboembolism is proven or strongly suspected and anticoagulation is absolutely contraindicated, when anticoagulation fails with recurrent emboli despite therapeutic levels, or rarely as prophylaxis in very high risk patients who cannot be anticoagulated. Filters do not treat the thrombus itself and carry risks of IVC thrombosis and migration. Routine use in elective orthopaedic surgery is not recommended.
Reference: Grainger and Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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