What is a contraindication for IVC filter placement?

• A. Total thrombosis of the vena cava
• B. Normal renal function
• C. Uncomplicated DVT
• D. Chronic venous insufficiency

Answer: (A)

The main concept is that an IVC filter is used to prevent pulmonary embolism in patients who cannot be anticoagulated or who have a high PE risk, by catching emboli from leg DVTs before they reach the lungs. If the vena cava is completely thrombosed, there’s no open lumen for the filter and emboli from below can’t travel to the lungs because the flow is already blocked; placing a filter would be unnecessary and could worsen thrombosis or cause other complications. Therefore total caval thrombosis is an absolute contraindication. Normal renal function, uncomplicated DVT, and chronic venous insufficiency do not by themselves preclude filter placement; the decision hinges on anticoagulation status and PE risk.