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We report our preliminary experience with the Bird's Nest inferior vena cava filter. Six patients, three men and three women, mean age 71 years (range 25-86), were considered for a Bird's Nest Filter during a 28-month period. Indications were contraindications to anticoagulation in two patients and insufficient effect of anticoagulant therapy in four patients. Three patients succumbed before filter placement. Two filters were placed percutaneously via the right common femoral vein and one via the left common femoral vein. All three filters were inserted successfully without complications. One patient died of multi-organ-failure 25 days after the filter insertion. Two patients are without any complaints and have normal ultrasound examinations 90 and 350 days after filter placement. It is uncommon to insert IVC filters in Denmark, we recommend that it be done by interventional radiologists.

By means of a questionnaire we studied the current indications for and the extent of the use of vena cava filters (VCF) in 325 Danish hospital departments. Two hundred and eighty (86%) responded. Only six clinical and four radiological departments (4%) used VCF. Eighteen percent did not find any indications for the use of VCF, 32% were not familiar with the method, and 46% replied that they did not have the relevant patient population. The reported indications for VCF are consistent with the international guidelines. We discussed the scientific background, indications and limitations for the use of VCF and concluded that the current use of VCF in Denmark probably is less than optimal. VCF should be considered in patients with pulmonary embolism or at high risk of pulmonary embolism when anticoagulant therapy is contraindicated.