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Currently, there are more than 10 permanent and optional retrievable vena cava filters in use in North America and Europe. Indications for inferior vena cava (IVC) filter placement are intuitive and filters are used in patients who have deep venous thrombosis (DVT) and contraindications to anticoagulation, or in patients who hemorrhage while anticoagulated for DVT. Multiple studies have proposed broadening the use of IVC filters as primary venous thromboembolism (VTE) prophylaxis in certain patient populations. Many permanent IVC filters have been well studied and have superior performance characteristics. On the other hand, optional retrievable IVC filters are attractive in the patient with a well-defined, short-term risk for VTE and contraindications to anticoagulation. Filter retrieval after the patient can be anticoagulated would eliminate the long-term risk of DVT associated with permanent IVC filter placement. Unfortunately, most optional retrievable filters are relatively new and have little to no data on their long-term performance when used as permanent filters, and the percentage of retrievable filters actually removed is less than 50%. The spirited debate concerning which patient should get which filter is just beginning. More prospective, randomized trials evaluating optional retrievable filters are needed to answer these important questions. [Copyright &y& Elsevier]

Discusses the search for drugs to treat and prevent strokes. Development testing on antiplatelet therapies, neuroprotective agents, and thrombolytic agents; How the European/Australian Stroke Prevention in Reversible Ischemia Trial (ESPRIT) is comparing the efficacy and safety of mild anticoagulation; Governmental involvement in the research of stoke prevention.