There's no end to topics and tangents that we could go off on with pulmonary embolism,

but I do want to cover a few more things before we close out pulmonary embolism and move on to different lectures.

And one of the things that is still overused in the treatment, and I hate to use the word treatment,

because it's not really a treatment, but one of the things that's overused is inferior venicava filters.

Both the American and the European guidelines do not recommend routine use of IVC filters in patients with acute pulmonary embolism.

If you can be treated with anticoagulants, meaning if you're able to start anticoagulation,

is there a benefit to adding an IBC filter?

So let's look at the evidence on this for a minute.

So there were two trials that often get quoted.

One is the first preptic trial.

So that's P-R-E-P-I-C, and that was in circulation in 2005 in July that year.

And that was an eight-year follow-up of patients with permanent Venicava filters in the prevention of pulmonary embolism.

It was called the PEPT trial because the title of it is Prevention to the Risk

to Embolai Pomeronear Interruption Cave.

I can't really do a French accent.

But anyway, that's what it was called.

So at eight years, they looked at these patients and didn't help survival.

Actually, it had no effect on survival if you put in one of these permanent IVC filters in this randomized trial.

So the thing they also looked at is deep pain thrombosis, and probably not surprising if you put in a foreign thing like an iBC

filter it actually increased the dvt rate now it should be noted that the number of pulmonary

embolisms actually did decrease in those that got the IBC filter.

But again, just because you got the filter and decreased the rate of pulmonary embolisms,

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