Complications Post Inferior Vena Cava Filter Placement (original) (raw)
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Vena cava filters and inferior vena cava thrombosis
Journal of Vascular …, 2007
Retrievable vena cava filters (R-VCF) are a recent addition to the therapeutic armamentarium for the prevention of pulmonary embolism. However, unlike permanent vena cava filters (P-VCF), outcomes data are limited regarding complication rates. Methods: This was a retrospective comparative analysis of consecutive patients undergoing placement of R-VCF vs P-VCF at Wake Forest University School of Medicine from January 2000 to December 2004. Data collected included demographics, procedural specifics, filter type, indications, and complications. Summary data are expressed as number (percentage) or mean ؎ SD. Continuous and categorical variables were analyzed by using t and Fisher exact testing, as appropriate. Four additional patients with vena cava thrombosis were also referred to our institution for treatment during the study period, all with opposed biconical VCFs (OptEase and TrapEase filters) recently placed at other facilities. This last group of patients is described but not included in the analysis. Results: A total of 189 VCF (165 P-VCF and 24 R-VCF) cases were examined. No significant differences in VCF groups were observed according to age, documented hypercoagulability, or concomitant anticoagulation. Significant differences were observed according to sex (30.3% of P-VCF vs 62.5% of R-VCF patients were female), morbid obesity (4.2% of P-VCF vs 25% of R-VCF patients), active malignancy (20% of P-VCF vs 41.7% of R-VCF patients), and indication for VCF placement. Over a median follow-up of 8.5 months, no case of significant hemorrhage, no VCF migration, and four cases of vena cava thrombosis were observed. Vena cava thrombosis was observed more frequently in the presence of R-VCF when compared with P-VCF (12.5% vs 0.6%; P ؍ .007). All observed vena cava thromboses were associated with severe clinical symptoms and occurred in patients who received opposed biconical VCF designs. Conclusions: In our experience, both P-VCF and R-VCF can be placed safely. Among both permanent and retrievable devices, however, opposed biconical designs seem to be associated with an increased risk for vena cava thrombosis. Although causative factors remain unclear, filter design and resultant flow dynamics may play an important role, because all episodes of vena cava thrombosis occurred in patients with a single-filter design.
Inferior Vena Cava Filters: Two Years Experience in
2016
Abstract. Pulmonary embolism remains a serious challenge for health care. Anticoagulation is considered the first line of treatment; however, in patients with anticoagulation failure or contraindication, inferior vena cava filter placement has been widely performed for the prevention of pulmonary embolism. This study is a retrospective review of King Abdulaziz University Hospital two years experience (2008-2009). Nineteen patients who had venous thromboembolic manifestations were subjected to inferior vena cava filter insertion. The main reasons for inferior vena cava filter insertion were the occurrence of venous thromboembolism on top of anticoagulants, and bleeding resulted from heparin induced thrombocytopenia. All of the patients were presented with one or more risk factors and co-morbidities among malignancies were the most common (52.6%). Insertion was successful for all cases, except one patient who had pre-existing massive inferior vena cava thrombosis. No complications wer...
Complications of vena cava filters: A comprehensive clinical review
2008
Despite the success of aggressive prophylaxis and screening, the occurrence of DVT and/or PE is not likely to be further reduced. The traditional treatment algorithm of anticoagulation therapy has been very effective. Heparin therapy has been shown to decrease the risk of fatal PE by 75% and to reduce the risk of recurrent PE from 25% to 2%. Long-term therapy with warfarin reduces the incidence of documented DVT from 47% to 2%. However, some patients have contraindication(s) to anticoagulation or prove intolerant of therapy. For this group of patients, a vena cava filter (VCF) may be of benefit. While VCF and the techniques of VCF deployment have evolved significantly over the last four decades, significant complications related to VCF are occasionally seen. This review provides a comprehensive overview of reported VCF-related complications.
Journal of Clinical Medicine
Objectives: to present an interventional radiology standard of practice on the use of inferior vena cava filters (IVCFs) in patients with or at risk to develop venous thromboembolism (VTE) from the Iberoamerican Interventional Society (SIDI) and Spanish Vascular and Interventional Radiology Society (SERVEI). Methods: a group of twenty-two interventional radiologist experts, from the SIDI and SERVEI societies, attended online meetings to develop a current clinical practice guideline on the proper indication for the placement and retrieval of IVCFs. A broad review was undertaken to determine the participation of interventional radiologists in the current guidelines and a consensus on inferior vena cava filters. Twenty-two experts from both societies worked on a common draft and received a questionnaire where they had to assess, for IVCF placement, the absolute, relative, and prophylactic indications. The experts voted on the different indications and reasoned their decision. Results: ...
Inferior Vena Cava Filters: Two Years Experience in King Abdulaziz University Hospital
Journal of King Abdulaziz University-Medical Sciences, 2010
Pulmonary embolism remains a serious challenge for health care. Anticoagulation is considered the first line of treatment; however, in patients with anticoagulation failure or contraindication, inferior vena cava filter placement has been widely performed for the prevention of pulmonary embolism. This study is a retrospective review of King Abdulaziz University Hospital two years experience (2008-2009). Nineteen patients who had venous thromboembolic manifestations were subjected to inferior vena cava filter insertion. The main reasons for inferior vena cava filter insertion were the occurrence of venous thromboembolism on top of anticoagulants, and bleeding resulted from heparin induced thrombocytopenia. All of the patients were presented with one or more risk factors and co-morbidities among malignancies were the most common (52.6%). Insertion was successful for all cases, except one patient who had pre-existing massive inferior vena cava thrombosis. No complications were recorded during filter insertion or on the short term, after filter insertion. Medical indications for inferior vena cava filters in our hospital are not different from what was cited in the literature. Although, each individual patient had multiple risk factors and co-morbidities, nevertheless our patients had no complications related to inferior vena cava filter insertion, which denotes that inferior vena cava filters can be inserted properly and safely.
Annals of vascular surgery, 2005
While contrast venography is considered the gold standard for imaging prior to inferior vena cava (IVC) filter insertion, bedside placement via transabdominal duplex ultrasound (DUS) has been recognized as a safe and effective alternative. To date, there has been no direct comparison of the efficacy of both imaging modalities for IVC filter placement. A concurrent cohort of patients who underwent IVC filter placement at a single institution over a 7-year period with either contrast venography or transabdominal DUS performed at bedside was retrospectively reviewed. Patient demographics, venous thromboembolism risk factors, indications, technical success, and procedural complications were compared. Of 439 patients initially imaged with transabdominal DUS, IVC filter placement was determined to be technically feasible in 382 patients (87%). The procedural technical success rate for IVC filter placement using transabdominal DUS when IVC visualization was adequate was 97.4% (n = 382 pati...
Lessons learned from a 6-year clinical experience with superior vena cava Greenfield filters
Journal of Vascular Surgery, 2000
Although therapy for upper extremity deep venous thrombosis (UEDVT) remains controversial, our group has chosen to treat UEDVT as aggressively as we treat lower extremity DVT (LEDVT). This approach is supported by the incidence of pulmonary embolism (PE) ranging from 4% to 28% in patients with UEDVT, which it makes it comparable to that of LEDVT. 1-8 Consequently, we have tried to systemically anticoagulate these patients with UEDVT by means of a full course of heparin and warfarin. However, treatment for those patients found to have an UEDVT who have contraindications to anticoagulation or who have a PE despite adequate anticoagulation has not well been addressed in the literature. We propose that these patients would benefit from the placement of a superior vena cava (SVC) filter. Our previously reported experience with SVC filters demonstrated the clinical feasibility of the placement of filters in the SVC. Nevertheless, there is scant follow-up in the literature examining a large series of patients undergoing placement of SVC filters. Issues concerning long-term efficacy, SVC thrombosis, migration of the filter, and perforation of the SVC have not been addressed. On the basis of our recent experience, we discuss the values and limitations of the placement of SVC filtration devices in the acute setting.
Complications Related to Inferior Vena Cava Filters: A Single-Center Experience
Annals of Vascular Surgery, 2010
We reviewed our experience with the different types of inferior vena cava (IVC) filters used over 4 years for the incidence of complications and correlated this with the type of filter used. This is a retrospective study involving chart reviews of all the patients who received IVC filters placed between January 2002 and January 2006. Data related to indications for filter insertion and the incidence of early (30 days) and late complications related to the filter insertion were collected. Complications were correlated to the type of filter and the indication for insertion. Statistical analysis was done using Fisher's exact test, and p<0.05 was considered significant. During this period 400 filters were inserted. There were 199 males (49.7%) and 201 females (50.25%). The mean patient age was 61 years (range 17e86). Filters used included TrapEase in 224 (56%), Greenfield filter in 95 (23.8%), Gunther-Tulip in 42 (10.5%), Bard recovery nitinol (all first-generation) in 34 (8.5%), and Simon Nitinol filter in five (1.2%). The indications for IVC filter insertion included acute venous thromboembolism (VTE) event in 273 patients (68.25%) and pulmonary embolism (PE) prophylaxis in 127 (31.75%) patients. In the group with VTE, 59 (21.6%) had contraindication for anticoagulation and 34 (12.5%) had hypercoagulable/malignant conditions. In the 127 patients who received the filter for PE prophylaxis in the absence of VTE, 107 (84.3%) had fractures, 43 (33.9%) had head injury, 32 (25.2%) had multiple trauma, and 15 (11.8%) had paralysis. Sixteen (12.6%) of the prophylaxis patients had IVC filter insertion prior to an elective surgical procedure. Complications in the form of hematoma at the site of filter insertion occurred in four (1%) patients, ipsilateral limb deep vein thrombosis in 15 (3.8%) patients, migration/tilt of filter in six (1.5%) patients, PE in six (1.5%) patients, and IVC thrombosis in 19 (4.75%) patients. Migration/tilt was higher in Bard filters compared to other filters, individually (p<0.004) and as a group (11.8% vs. 0.55%, p<0.0005). All other complication had a comparable incidence in all filters. However, in the group of patients (n¼34) who had hypercoagulable/malignant conditions, the incidence of IVC thrombosis was higher with TrapEase filters compared to all other filters as a group (25% vs. 0%, p<0.05). In conclusion, IVC filters are frequently used for prophylaxis in the absence of VTE conditions. Complications are relatively low. All types of filters used in this study had comparable complications with the exception of the Bard filter, which had a higher incidence of tilt, and the TrapEase filter, which had a higher incidence of IVC thrombosis, in patients with hypercoagulable/malignant conditions.
Retrograde Insertion of Inferior Vena Cava (IVC) Filter: A Bailout Plan
Journal of Surgery Research and Practice, 2023
Venous thromboembolism poses a significant threat to patient health and remains a leading cause of preventable morbidity and mortality. To mitigate the risk of pulmonary embolism resulting from deep vein thrombosis, the insertion of an Inferior Vena Cava (IVC) filter has become a critical intervention. While several approaches are available for IVC filter placement, the internal jugular approach has gained recognition for its unique advantages. This case study provides a comprehensive examination of an 85-year-old female patient who underwent IVC filter insertion through the internal jugular approach with an indication of extensive bilateral iliac venous thrombosis, secondary to femoral vein dialysis catheter. By exploring the clinical experience and outcomes associated with this specific technique, we aim to elucidate the benefits, considerations and potential implications for future practice. Through an in-depth analysis of this case, interventional radiologists, clinicians and healthcare professionals involved in venous thromboembolism management can gain valuable insights into the safety, efficacy and patientcentered outcomes of the internal jugular approach for IVC filter insertion.