Indications, management, and complications of temporary inferior vena cava filters.
ABSTRACT We describe the results of a preliminary prospective study using different recently developed temporary and retrievable inferior vena cava (IVC) filters.
Fifty temporary IVC filters (Günther, Günther Tulip, Anthéor) were inserted in 47 patients when the required period of protection against pulmonary embolism (PE) was estimated to be less than 2 weeks. The indications were documented deep vein thrombosis (DVT) and temporary contraindications for anticoagulation, a high risk for PE, and PE despite DVT prophylaxis.
Filters were removed 1-12 days after placement and nine (18%) had captured thrombi. Complications were one PE during and after removal of a filter, two minor filter migrations, and one IVC thrombosis.
Temporary filters are effective in trapping clots and protecting against PE, and the complication rate does not exceed that of permanent filters. They are an alternative when protection from PE is required temporarily, and should be considered in patients with a normal life expectancy.
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ABSTRACT: Despite advances in thromboprophylaxis, venous thromboemb-olism remains a significant problem in major orthopaedic surgery, associated with significant morbidity and high cost of treatment. Virchow's triad, as well as patient and procedural risk factors, put many orthopaedic surgery patients at high risk. Diagnosis is based on clinical suspicion in combination with imaging such as ultrasound. Options for prophylaxis include aspirin, warfarin, low-molecular weight heparins and direct inhibitors of coagulation factors. In this review, we discuss the latest American Academy of Orthopaedic Surgeons (AAOS) and American College of Chest Physicians (ACCP) guidelines for prevention of venous thromboembolism and their implications for practice.Current Orthopaedic Practice 05/2013; 24(3):312.
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ABSTRACT: Data regarding inferior vena cava (IVC) filter use and complications are scarce. This study evaluates the safety and efficacy of IVC filters over a 4-year period at two adult tertiary care hospital sites. A retrospective observational study was conducted of consecutive admitted patients who underwent insertion of an IVC filter between 1 January 2007 and 31 December 2010. The main objective of the study was to evaluate the safety and efficacy of IVC filters. We identified 338 patients with an attempted filter insertion who were followed for a median 16.3 months. Ninety-one percent of filters inserted were for an appropriate indication. Sixty-eight patients (20% of all patients) had one or more filter-related complication. Despite a median time after filter insertion to start anticoagulation of 2 days (interquartile range 3 days) for prophylactic and 6 days (interquartile range 7 days) for full dose, 38 patients (11% of all patients) had one or more thrombotic complications during follow-up. In a subgroup of patients with complete anticoagulation information available, thrombotic complications occurred in 18, 16, and 8% of patients receiving no, prophylactic, or full dose anticoagulation after IVC filter insertion, respectively (NS; P = 0.13). IVC filter use in our study was associated with a substantial rate of complications including thrombotic complications. This study highlights the need for further research regarding the safety and efficacy of IVC filters and the role for early initiation of anticoagulation.Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 01/2014; · 1.25 Impact Factor
- Réanimation Urgences 01/2001; 10(5).