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Peress L, Kamil S, Fernandez M, Lastimosa R, Jaffer O, Patel S, Akhtar MR, Kyaw Tun J. Improving the practice of inferior vena cava filter retrieval: a quality improvement intervention and audit outcomes. Br J Radiol 2019; 92:20190051. [PMID: 31204842 DOI: 10.1259/bjr.20190051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To review inferior vena cava (IVC) filter retrieval practice at our institution, the Royal London Hospital, and measure changes following a quality improvement intervention. IVC filters are a preventive treatment for pulmonary embolism when anticoagulation is ineffective/contraindicated. Unless permanent filtration is required, all filters should undergo attempted retrieval within manufacturer's recommendations with a success rate of ≥80 %. METHODS Retrospective audit of filters inserted between 2011 and 2014, followed by a quality improvement intervention and a second audit between 2015 and 2017. Clinical-radiological data were analysed using the Picture Archiving and Communication System and electronic patient records. RESULTS During the first audit, filter retrieval was attempted in 92% of cases, of which 82% underwent the procedure within manufacturer's recommendations and 86% were successful. During the second audit, an improvement across indicators was seen. Retrieval increased by 3% and was attempted in 95% of cases (92% of which were within manufacturer's guidelines). Rate of retrievals within manufacturer's guidelines increased by 10%. Filter retrieval success rate increased by 11% - to 97%. CONCLUSIONS IVC filter retrieval practice at a single institution can be improved by implementing a simple audit intervention. ADVANCES IN KNOWLEDGE Filter retrieval practice has clinical and medicolegal implications. A simple quality intervention can substantially improve overall practice.
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Affiliation(s)
- Luisa Peress
- 1 Royal London Hospital, Barts Health NHS Trust, Whitechapel Rd, London, UK.,2 Barts and the London SMD, Queen Mary University, 4 Newark St, London, UK
| | - Sally Kamil
- 1 Royal London Hospital, Barts Health NHS Trust, Whitechapel Rd, London, UK.,3 The University of Jordan Queen Rania St, Amman, Jordan
| | - Maria Fernandez
- 1 Royal London Hospital, Barts Health NHS Trust, Whitechapel Rd, London, UK
| | - Rowena Lastimosa
- 1 Royal London Hospital, Barts Health NHS Trust, Whitechapel Rd, London, UK
| | - Ounali Jaffer
- 1 Royal London Hospital, Barts Health NHS Trust, Whitechapel Rd, London, UK
| | - Snehal Patel
- 1 Royal London Hospital, Barts Health NHS Trust, Whitechapel Rd, London, UK
| | | | - Jimmy Kyaw Tun
- 1 Royal London Hospital, Barts Health NHS Trust, Whitechapel Rd, London, UK
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Brahmandam A, Skrip L, Sumpio B, Indes J, Dardik A, Sarac T, Rectenwald J, Chaar CIO. A survey of vascular specialists' practice patterns of inferior vena cava filter placement and retrieval. Vascular 2018; 27:291-298. [PMID: 30501583 DOI: 10.1177/1708538118815394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The placement of inferior vena cava filters (IVCF) continues to rise. Vascular specialists adopt different practices based on local expertise. This study was performed to assess the attitudes of vascular specialists towards the placement and retrieval of IVCF. METHODS An online survey of 28 questions related to practice patterns regarding IVCF was administered to 1429 vascular specialists. Vascular specialists were categorized as low volume if they place less than three IVCF per month and high volume if they place at least three IVCF per month. The responses of high volume and low volume were compared using two-sample t-tests and Chi-square tests. RESULTS A total of 259 vascular specialists completed the survey (18% response rate). There were 191 vascular surgeons (74%) and 68 interventional radiologists (26%). The majority of responders were in academic practice (67%) and worked in tertiary care centers (73%). The retrievable IVCF of choice was Celect (27%) followed by Denali (20%). Forty-two percent used a temporary IVCF and left it in situ instead of using a permanent IVCF. Eighty-two percent preferred placing the tip of the IVCF at or just below the lowest renal vein. Thirty-one percent obtained a venous duplex of the lower extremities prior to retrieval while 24% did not do any imaging. There were 132 (51%) low volume vascular specialists and 127 (49%) high volume vascular specialists. Compared to low volume vascular specialists, significantly more high volume vascular specialists reported procedural times of less than 30 min for IVCF retrieval (57% vs. 42%, P = 0.026). There was a trend for high volume to have fewer unsuccessful attempts at IVCF retrieval but that did not reach statistical significance ( P = .061). High volume were more likely to have attempted multiple times to retrieve an IVCF (66% vs. 33%, P < .001), and to have used bronchoscopy forceps (32% vs. 14%, P = .001) or a laser sheath (14% vs. 2%, P < .001) for IVCF retrieval. In general, vascular specialists were not comfortable using bronchoscopy forceps (65%) or a laser sheath (82%) for IVCF retrieval. CONCLUSIONS This study underscores significant variability in vascular specialists practice patterns regarding IVCF. More studies and societal guidelines are needed to define best practices.
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Affiliation(s)
- Anand Brahmandam
- 1 Section of Vascular Surgery, Yale University School of Medicine, New Haven, USA
| | - Laura Skrip
- 2 National Public Health Institute of Liberia, Monrovia, Liberia
| | - Bauer Sumpio
- 1 Section of Vascular Surgery, Yale University School of Medicine, New Haven, USA
| | - Jeffrey Indes
- 3 Section of Vascular Surgery, Montefiore Medical Center, New York, USA
| | - Alan Dardik
- 1 Section of Vascular Surgery, Yale University School of Medicine, New Haven, USA
| | - Timur Sarac
- 4 Section of Vascular Surgery, Ohio State University Wexner Medical Center, Columbus, USA
| | - John Rectenwald
- 5 Section of Vascular Surgery, University of Wisconsin, Madison, USA
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Retrievable Inferior Vena Cava Filters in Trauma Patients: Prevalence and Management of Thrombus Within the Filter. Eur J Vasc Endovasc Surg 2016; 52:830-837. [PMID: 27692532 DOI: 10.1016/j.ejvs.2016.08.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 08/17/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The incidence of thrombus was investigated within retrievable filters placed in trauma patients with confirmed DVT at the time of retrieval and the optimal treatment for this clinical scenario was assessed. A technique called "filter retrieval with manual negative pressure aspiration thrombectomy" for management of filter thrombus was introduced and assessed. METHODS The retrievable filters referred for retrieval between January 2008 and December 2015 were retrospectively reviewed to determine the incidence of filter thrombus on a pre-retrieval cavogram. The clinical outcomes of different managements for thrombus within filters were recorded and analyzed. RESULTS During the study 764 patients having Aegisy Filters implanted were referred for filter removal, from which 236 cases (134 male patients, mean age 50.2 years) of thrombus within the filter were observed on initial pre-retrieval IVC venogram 12-39 days after insertion (average 16.9 days). The incidence of infra-filter thrombus was 30.9%, and complete occlusion of the filter bearing IVC was seen in 2.4% (18) of cases. Retrieval was attempted in all 121 cases with small clots using a regular snare and sheath technique, and was successful in 120. A total of 116 cases with massive thrombus and IVC occlusion by thrombus were treated by CDT and/or the new retrieval technique. Overall, 213 cases (90.3%) of thrombus in the filter were removed successfully without PE. CONCLUSIONS A small thrombus within the filter can be safely removed without additional management. CDT for reduction of the clot burden in filters was effective and safe. Filter retrieval with manual negative pressure aspiration thrombectomy seemed reasonable and valuable for management of massive thrombus within filters in some patients. Full assessment of the value and safety of this technique requires additional studies.
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Lee MJ, Valenti D, de Gregorio MA, Minocha J, Rimon U, Pellerin O. The CIRSE Retrievable IVC Filter Registry: Retrieval Success Rates in Practice. Cardiovasc Intervent Radiol 2015; 38:1502-7. [PMID: 25933644 DOI: 10.1007/s00270-015-1112-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 03/30/2015] [Indexed: 12/19/2022]
Abstract
CIRSE established a registry of retrievable filter use with the primary aim of determining the success of IVC Filter retrieval and associated complications. Secondary endpoints included filter indications, imaging strategies before retrieval, filter dwell times, and anticoagulation status. A web-based electronic registry was hosted between 01/12/2010 and 30/06/2012. Data entry occurred at the date of IVC filter retrieval and included items such as filter type, indication for filter insertion, access route, dwell time, retrieval success, complications, reasons for failed retrieval, and anticoagulation status. 671 filter retrievals were entered (male:female 333:295, mean age 55, median 57). Retrieval data were not entered in 43/671 leaving 628 patients for analysis. The 4 commonest retrievable filters used were the Celect in 182 patients, the OPTEASE in 161, ALN in 120, and Gunther Tulip in 98. Filters were inserted for absolute indications 40%, relative indications in 31%, and prophylactic in 24%, with 5% missing. Mean filter dwell time was 90 days. Filters were successfully retrieved in 576/628 patients (92%). The mean dwell time for successful retrievals was 85 days versus 145 days for unsuccessful retrievals (p = 0.001). Major complications occurred in 2 patients (0.03%). In summary, the CIRSE retrievable filter registry demonstrates a retrieval rate of 92% across a range of filter types, with a low major complication rate, reflecting current practice. There is an increase in trend of retrievable filter use for relative and prophylactic indications.
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Affiliation(s)
- M J Lee
- The Department of Academic Radiology, Beaumont Hospital, Dublin 9, Ireland.
| | - D Valenti
- Department of Radiology, McGill University, 354 Beaconsfield Blvd, Montreal, QC, H9W4A9, Canada.
| | - M A de Gregorio
- Department of Interventional Radiology, University of Zaragoza, Gomez Laguna, 13, 5° B, 50009, Saragossa, Spain.
| | - J Minocha
- Department of Radiology, University of Illinois Hospital & Health Sciences System, 1740 West Taylor Street, Suite 2483, Chicago, IL, 60612, USA.
| | - U Rimon
- Department of Diagnostic Radiology, Sheba Medical Center, 52621, Telhasomer, Israel.
| | - O Pellerin
- Department of Interventional Radiology, Université Paris 5 René Descartes, Hopital Européen Georges, Pompidou, 20 rue Leblanc, 75908, Paris, France.
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El-Daly I, Reidy J, Culpan P, Bates P. Thromboprophylaxis in patients with pelvic and acetabular fractures: A short review and recommendations. Injury 2013; 44:1710-20. [PMID: 23816168 DOI: 10.1016/j.injury.2013.04.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Revised: 04/07/2013] [Accepted: 04/28/2013] [Indexed: 02/02/2023]
Abstract
The management of thromboprophylaxis in patients with pelvic and acetabular fractures remains a highly controversial topic within the trauma community. Despite anticoagulation, venous thromboembolism (VTE) remains the most common cause of surgical morbidity and mortality in this high-risk patient group. Although various thromboprophylactic regimes are employed, evidence relating to the most effective method remains unclear. Controversies surrounding screening, the use of prophylactic inferior vena cava filters (IVCF) and chemothromboprophylaxis in polytraumatised patients, particularly those with pelvic and acetabular fractures, form the basis of considerable debate. With the absence of a well-designed clinical trial and the presence of ongoing controversies within the literature, this review will explore current treatment options available to trauma surgeons and highlight differing scientific opinions, providing an update on the role of screening and current available preventative measures. We cover existing as well as recent advances in chemical thromboprophylactic agents and discuss external mechanical compression devices, the usefulness of serial duplex ultrasonography and the role of extended chemothromboprophylaxis on discharge. The evidence behind prophylactic IVCF is also considered, along with reported complication profiles. We conclude with a proposed protocol for use in major trauma centres, which can form the basis of local policy for the prevention of VTE in trauma patients with pelvic and acetabular fractures.
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Affiliation(s)
- Ibraheim El-Daly
- The Royal London Hospital, Barts Health NHS Trust, Department of Trauma and Orthopaedic Surgery, Whitechapel, London E1 1BB, UK.
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Seinturier C, Dornier C, Thony F, Blaise S, Rodière M, Menez C, Arnoult AC, Imbert B, Pernod G. [Temporary vena caval filters: report on cohort of 72 patients in Grenoble, France]. ACTA ACUST UNITED AC 2013; 38:335-40. [PMID: 24016707 DOI: 10.1016/j.jmv.2013.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 07/08/2013] [Indexed: 11/28/2022]
Abstract
Patients with a contra-indication for anticoagulation can benefit from temporary vena caval filters for protection against pulmonary embolism or recurrence. The filter can be removed secondarily, once the contra-indication is overcome, enabling better long-term outcome by reducing the risk of thrombotic and mechanic complications inherent in these devices. However, it has been shown in several studies that effective withdrawal rates were low and could be improved by the establishment of protocols and registries. We report a retrospective study of withdrawal in 72 patients in whom an ALN® vena caval filter was implanted at the Grenoble University Hospital over a period of three years with an intention for secondary retrieval. Seventy percent of the indications were related to the coexistence of thrombotic and hemorrhagic conditions. Fifty-five percent of filters were removed, the remaining 45% shared involved patients who died before retrieval (11%), those lost to follow-up (4%), technical failure of retrieval (6%), withdrawal technically unfeasible (3%), retrieval refused by patients (6%) and medical indications for continuing filtration (15%). Despite an effective follow-up of these patients and 91% success rate of withdrawal, nearly one out of two filters remains in place. A long-term follow-up of these patients is needed to learn more about the outcome of these filters.
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Affiliation(s)
- C Seinturier
- Clinique universitaire de médecine vasculaire, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 9, France.
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Uberoi R, Tapping CR, Chalmers N, Allgar V. British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry. Cardiovasc Intervent Radiol 2013; 36:1548-1561. [DOI: 10.1007/s00270-013-0606-2] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Accepted: 01/19/2013] [Indexed: 11/24/2022]
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Mellado Joan M, Clarà Velasco A, Paredes Mariñas E, Calsina Juscafresa L, Mateos Torres E. Cambios en la práctica clínica tras la introducción de los filtros de vena cava retirables. ANGIOLOGIA 2013. [DOI: 10.1016/j.angio.2012.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Ryu RK, Parikh P, Gupta R, Eifler AC, Salem R, Omary RA, Lewandowski RJ. Optimizing IVC Filter Utilization: A Prospective Study of the Impact of Interventional Radiologist Consultation. J Am Coll Radiol 2012; 9:657-60. [DOI: 10.1016/j.jacr.2012.05.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 05/14/2012] [Indexed: 11/25/2022]
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10
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Li W, Gorecki P, Semaan E, Briggs W, Tortolani AJ, D'Ayala M. Concurrent prophylactic placement of inferior vena cava filter in gastric bypass and adjustable banding operations in the Bariatric Outcomes Longitudinal Database. J Vasc Surg 2012; 55:1690-5. [DOI: 10.1016/j.jvs.2011.12.056] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 12/09/2011] [Accepted: 12/22/2011] [Indexed: 01/10/2023]
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Angel LF, Tapson V, Galgon RE, Restrepo MI, Kaufman J. Systematic review of the use of retrievable inferior vena cava filters. J Vasc Interv Radiol 2012; 22:1522-1530.e3. [PMID: 22024114 DOI: 10.1016/j.jvir.2011.08.024] [Citation(s) in RCA: 328] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 08/18/2011] [Accepted: 08/18/2011] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To review the available literature on retrievable inferior vena cava (IVC) filters to examine the effectiveness and risks of these devices. MATERIALS AND METHODS Investigators searched MEDLINE for clinical trials evaluating retrievable filters and reviewed the complications reported to the Manufacturer and User Facility Device Experience (MAUDE) database of the U.S. Food and Drug Administration (FDA). RESULTS Eligibility criteria were met by 37 studies comprising 6,834 patients. All of the trials had limitations, and no studies were randomized. There were 11 prospective clinical trials; the rest were retrospective studies. Despite the limitations of the evidence, the IVC filters seemed to be effective in preventing pulmonary embolism (PE); the rate of PE after IVC placement was 1.7%. The mean retrieval rate was 34%. Most of the filters became permanent devices. Multiple complications associated with the use of IVC filters were described in the reviewed literature or were reported to the MAUDE database; most of these were associated with long-term use (> 30 days). At the present time, the objective comparison data of different filter designs do not support superiority of any particular design. CONCLUSIONS In high-risk patients for whom anticoagulation is not feasible, retrievable IVC filters seem to be effective in preventing PE. Long-term complications are a serious concern with the use of these filters. The evidence of the effectiveness and the risks was limited by the small number of prospective studies.
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Affiliation(s)
- Luis F Angel
- Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
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Retrievable Inferior Vena Cava Filters: Factors that Affect Retrieval Success. Cardiovasc Intervent Radiol 2011; 35:1059-65. [DOI: 10.1007/s00270-011-0268-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 08/18/2011] [Indexed: 10/15/2022]
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Kim HJ, Chang NK, Lim JH, Kim JK. Fracture of a Tempofilter II: an initial case report. Korean J Radiol 2011; 12:626-8. [PMID: 21927565 PMCID: PMC3168805 DOI: 10.3348/kjr.2011.12.5.626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 02/22/2011] [Indexed: 11/15/2022] Open
Abstract
Tempofilter II is a device that is used for pulmonary embolism prophylaxis. Since the appearance of the Tempofilter II following withdrawal of the Tempofilter I, it has been reported that the Tempofilter II is safe, effective and useful. Here we report on the first case of a fracture of one leg of the filter and this leg was embedded in the inferior vena cava wall in a 62-year-old man with deep vein thrombosis.
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Affiliation(s)
- Hyung Jun Kim
- Department of Radiology, Chonnam National University Hospital, Gwangju 501-757, Korea
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Abstract
Trauma patients are at exceedingly high risk of development of venous thromboembolism (VTE) including deep venous thrombosis and pulmonary embolism (PE). The epidemiology of VTE in trauma patients is reviewed. PE is thought to be the third major cause of death after trauma in those patients who survive longer than 24 hours after onset of injury. In fact, patients recovering from trauma have the highest rate of VTE among all subgroups of hospitalized patients. Various prophylactic and surveillance methods have been evaluated and found helpful in certain situations, but VTE complications can occur despite such measures. Therapeutic and prophylactic uses of inferior vena cava (IVC) filters in trauma patients are reviewed. Prophylactic IVC filter use is revealed to be a controversial subject with valid arguments on both sides of the issue. With the lack of prospective randomized trials of IVC filter use in trauma, it is impossible to make evidence-based recommendations. Unfortunately, two sets of guidelines are available for insertion of filters in trauma patients, with conflicting recommendations. The introduction of retrievable IVC filters seems to offer a unique solution for VTE protection in the trauma patient population, which often consists of younger members of our population. Lastly, current generations of FDA-approved retrieval filters are discussed.
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Affiliation(s)
- Hamed Aryafar
- UCSD Medical Center, Department of Radiology, San Diego, California
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O’Sullivan GJ. The Role of Interventional Radiology in the Management of Deep Venous Thrombosis: Advanced Therapy. Cardiovasc Intervent Radiol 2010; 34:445-61. [DOI: 10.1007/s00270-010-9977-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Accepted: 08/09/2010] [Indexed: 02/03/2023]
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Kalva SP, Marentis TC, Yeddula K, Somarouthu B, Wicky S, Stecker MS. Long-Term Safety and Effectiveness of the “OptEase” Vena Cava Filter. Cardiovasc Intervent Radiol 2010; 34:331-7. [DOI: 10.1007/s00270-010-9969-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 08/09/2010] [Indexed: 10/19/2022]
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Moore PS, Andrews JS, Craven TE, Davis RP, Corriere MA, Godshall CJ, Edwards MS, Hansen KJ. Trends in vena caval interruption. J Vasc Surg 2010; 52:118-125.e3; discussion 125-6. [DOI: 10.1016/j.jvs.2009.09.067] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 09/01/2009] [Accepted: 09/05/2009] [Indexed: 11/29/2022]
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Rajasekhar A, Crowther M. Inferior vena caval filter insertion prior to bariatric surgery: a systematic review of the literature. J Thromb Haemost 2010; 8:1266-70. [PMID: 20345723 DOI: 10.1111/j.1538-7836.2010.03858.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Placement of inferior vena cava filters (IVCFs) is considered in many patients undergoing bariatric surgery. Their placement is driven by a high rate of pulmonary embolism (PE), uncertainty as to the effectiveness of pharmacologic prophylaxis, and a lack of alternate methods to prevent pulmonary embolism. We performed a systematic review of the literature to evaluate the evidence supporting placement of IVCFs in patients undergoing bariatric surgery. Eleven studies were identified; none were randomized trials. Descriptive analysis suggests that IVCFs reduced PE; however, the strength of this observation is tempered by the lack of use of effective forms of prophylaxis and the failure to account for complications of IVCF placement. We conclude, pending the results of controlled studies, that the use of IVCFs cannot be recommended for routine patients undergoing bariatric surgery.
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Affiliation(s)
- A Rajasekhar
- Department of Medicine, University of Florida, Gainesville, FL, USA
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Saito N, Shimamoto T, Takeda T, Marui A, Kimura T, Ikeda T, Sakata R. Excimer Laser–assisted Retrieval of Günther Tulip Vena Cava Filters: A Pilot Study in a Canine Model. J Vasc Interv Radiol 2010; 21:719-24. [DOI: 10.1016/j.jvir.2010.01.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Revised: 11/18/2009] [Accepted: 01/05/2010] [Indexed: 10/19/2022] Open
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Raman R, Leming PD, Bhandari M, Long D, Streiff MB. Inferior vena cava filters in the management of cancer-associated venous thromboembolism: a systematic review. Oncol Rev 2010. [DOI: 10.1007/s12156-010-0042-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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