Retrievable inferior vena cava filter added to anticoagulation,
does it really help with Reduced three-month symptomatic pulmonary-embolism recurrence in anticoagulatable severe acute pulmonary embolism?
research showsThe grade is D with 34 points. In PREPIC2, symptomatic pulmonary embolism recurred by three months in 6/200 (3.0%, all fatal) with a filter versus 3/199 (1.5%, two fatal) with anticoagulation alone, RR 2.00 (95% CI 0.51 to 7.89; P=.50). There was no benefit, but the very wide interval excludes neither substantial benefit nor substantial harm, so this is D rather than F.
ads claimThe device is designed to trap embolizing clot, but that physical function did not translate into fewer recurrences when added to modern full-dose anticoagulation in this population.
Useful facts when choosing a product
- A retrievable inferior vena cava filter is implanted to trap clot traveling from the lower limbs.
- Every PREPIC2 participant received at least six months of full-dose anticoagulation, with retrieval planned at three months.
- Insertion succeeded in 193 patients, and three filter thromboses were reported.
What the research actually shows
This open-label, blinded-endpoint trial at 17 French hospitals randomized 399 patients, 200 to filter and 199 to control. Only one participant lacked primary-outcome information and was treated as missing. Public and nonprofit grants were combined with free filters from ALN Implants Chirurgicaux. The earlier PREPIC trial used permanent filters in a broader proximal-DVT population and was not counted as independent replication of this retrievable-filter acute-PE question. Allocation used a central 24-hour interactive voice-response system that ensured concealment. Procedural participant masking was infeasible, while all efficacy and safety outcomes were reviewed by a central committee blinded to assignment. All analyses used the intention-to-treat population defined as all randomized patients, and unavailable outcomes were treated as missing. The prespecified three-month fatal or symptomatic nonfatal recurrent pulmonary-embolism endpoint matched NCT00457158.
Why this is classified as D (34)
A well-conducted hard-outcome trial found no benefit, but its interval retained substantial benefit, giving D with 34 points.
Counterpoint. Patients with contraindications to anticoagulation, for whom a filter may be the only option, were excluded.
Rejudgment record. Cross-check applied — Cross-checked PREPIC2, its protocol, and NCT00457158 for central allocation, blinded adjudication, ITT and missingness, prespecified endpoint, mixed support, and the wide confidence interval
| Endpoint | H | Hard endpoint - actual events such as death |
| Replication | R1 | Single confirmatory trial |
| Independence | I1 | Mixed funding sources |
| Effect size | E0 | Null |
| Precision | C0 | The confidence interval leaves room for benefit |
The scoring table and the verdict agree (D).
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| Reduced symptomatic pulmonary-embolism recurrence at three months | D | RR was 2.00 (0.51 to 7.89), null and imprecise. |
| Reduced recurrence when anticoagulation is contraindicated | ? | This population was excluded from the trial. |
Cross-check — Codex and Claude
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| Study 1 | Multicenter open-label randomized trial with blinded endpoint adjudication | 1 | French public and nonprofit grants; filters supplied free by ALN | Fatal or symptomatic nonfatal recurrent pulmonary embolism at three months | 6/200 (3.0%) versus 3/199 (1.5%), RR 2.00 (95% CI 0.51 to 7.89), P=.50 | Direct null hard-outcome evidence from one imprecise trial |
Receipt — 1 References
All 1 cited sources were verified for existence at the original page (as of 2026-08-18).
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-18 · Corrections: none
Cite this verdict
[Chamgap] Retrievable inferior vena cava filter added to anticoagulation x recurrent severe acute pulmonary embolism — Evidence Grade D·34. 1 cited sources checked. Source: https://chamgap.com/en/verdicts/heart/retrievable-ivc-filter-anticoagulated-severe-pulmonary-embolism-recurrence/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
What this document does and does not do
Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.