IVC (Inferior Vena Cava) filtration aims to capture significant blood clots while maintaining IVC openness. Most filters share a cone-shaped design that allows clot trapping at the apex while preserving flow along the sides. There are three filter types: permanent, optional (retrievable), and convertible. Initially, permanent filters were used for over two decades. However, recent studies highlighted increased risks of subsequent DVT, filter migration, and IVC blockage with long-term usage. Optional filters were introduced for removal after PE risk or anticoagulation contraindication subsided. They can be retained as permanently if needed. Optional filters are now preferred, while permanent ones are for long-term IVC interruption or limited-survival cases. Low retrieval rates for optional filters are due to patient compliance, follow-up issues, clinical status changes, persistent PE risk, and death. To address this, convertible filters emerged, allowing the device to transform from a filter to a stent-like structure, adapting to patient needs.

Regarding mortality benefits, the PREPIC trial stands as the sole randomized controlled trial assessing the efficacy of IVC filters. However, it did not confirm any substantial survival advantage associated with IVC filters in comparison to using anticoagulants alone. While the trial demonstrated both short and long-term benefits in preventing pulmonary embolism recurrence through IVC filters, it also highlighted a notable rise in recurrent deep vein thrombosis (DVT) occurrences within this group.