Let’s talk about IVC filers in trauma patients. We all know the guidelines: Trauma patients with high risk for Venous Thromboembolism (severe head injury, spinal cord injury, LE fractures) should get a filter, right? Unfortunately, it’s not all that easy to decide in the real world practice who should get a filter. Some trauma patients are not eligible to be started on prophylactic anticoagulation, and are not “sick enough” to get a filter. Some patients get all they can get prophylaxis (TEDs, SCDs, even low dose Lovenox/Fragmin), yet still develop DVT (leg clots) and PE (emboli to lungs). Often it becomes a judgment call based on the expectations of the patient’s recovery. Having an option of placing a retrievable filter makes this decision somewhat easier – you can remove the filter later in necessary. Do I think that more trauma patients should get filters? No I don’t. The procedure itself has it’s own risks and once the filter is in, it can cause problems down the road (migration, vessel wall perforation etc.). Having more extensive guidelines on IVC filters might help in an everyday practice.