1
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Cooper PM, Maldjian P, Shukla P. Inferior vena cava filter fracture with strut migration on CT with volume rendering. Radiol Case Rep 2021; 16:3051-3054. [PMID: 34429800 PMCID: PMC8365444 DOI: 10.1016/j.radcr.2021.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/07/2021] [Indexed: 11/19/2022] Open
Abstract
We present the computed tomography findings in a patient with a fractured IVC filter and migration of a broken strut to the right lower quadrant. The filter morphology and strut fragment are well demonstrated on volume rendered images confirming the value of volumetric 3D computed tomography imaging to evaluate IVC filter integrity and identify migrated filter fragments.
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2
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Grabo DJ, Seery JM, Bradley M, Zakaluzny S, Kearns MJ, Fernandez N, Tadlock M. Prevention of Deep Venous Thromboembolism. Mil Med 2019; 183:133-136. [PMID: 30189059 DOI: 10.1093/milmed/usy072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Indexed: 11/12/2022] Open
Abstract
The nature of many combat wounds puts patients at a high risk of developing deep venous thrombosis (DVT) and pulmonary embolism (PE), which fall under the broader disease category of venous thromboembolism (VTE). In addition to the hypercoagulable state induced by trauma, massive injuries to the extremities, prolonged immobility, and long fixed wing transport times to higher echelons of care are unique risk factors for venous thromboembolism in the combat-injured patient. These risk factors mandate aggressive prophylaxis for DVT and PE that can effectively be achieved by the use of lower extremity sequential compression devices and low dose unfractionated heparin or low molecular weight heparin. In addition, inferior vena cava filters are often used for PE prophylaxis when chemical DVT prophylaxis fails or is contraindicated. The following Department of Defense (DoD) Joint Trauma System (JTS) Clinical Practice Guideline (CPG) discusses the current recommendations for the prevention of DVT and PE including the use of inferior vena cava filters (IVCFs).
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Affiliation(s)
- Daniel J Grabo
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Jason M Seery
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Matthew Bradley
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Scott Zakaluzny
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Michel J Kearns
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Nathanial Fernandez
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Matthew Tadlock
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
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3
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Yang C, Ma F, Gao C, Kang Y, Zhang G, Liu P, Jiang H, Chang Z. Design and evaluation of a novel biodegradable inferior vena cava filter. J Biomater Appl 2019; 33:1060-1069. [DOI: 10.1177/0885328218824203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Inferior vena cava filter has been increasingly applied in clinical practice to prevent pulmonary embolism. Nowadays, various complications after implanting conventional filters seriously hinder clinical applications. Therefore, in this paper, a novel biodegradable inferior vena cava filter was designed based on biodegradable materials, which is an hourglass-like filter anchored inside a stent structure fixed by connecting fibers. Firstly, mechanical tests in crimp were performed to study the expansion properties of the filter, showing that the biodegradable inferior vena cava filter could achieve self-expansion easily. Furthermore, the biodegradable inferior vena cava filters and fibers were incubated in phosphate buffer media (pH = 7.4 ± 0.2) at 37°C for six months. Scanning electron microscope micrograph showed that the stents exhibited no significant dimensional and structural changes and had enough radial force to support the vessel. During the degradation period, the results of scanning electron microscope, gel permeation chromatography, differential scanning calorimetry and tensile strength analysis confirmed that the degradation rate of the hourglass-like filter was faster than the connecting fibers, achieving progressive degradation and thus avoiding the polymer fragments from blocking vessel. Cytotoxicity and hemolysis assay demonstrated good biocompatibility of the filter. For 5 mm × 10 mm sized thrombus, in vitro simulated thrombus capture test showed that the mean trapping efficiency of the filter was 90%, which was comparable to traditional inferior vena cava filter. In conclusion, all results exhibited that the as-designed biodegradable inferior vena cava filter has a potential in clinical application for patients who are at temporary high risk of venous thromboembolism.
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Affiliation(s)
- Caihong Yang
- School of Materials Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Fengcang Ma
- School of Materials Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Chenguang Gao
- Shanghai MicroPort Medical (Group) Co., Ltd, Shanghai, China
| | - Yahong Kang
- Shanghai MicroPort Medical (Group) Co., Ltd, Shanghai, China
| | - Guoyi Zhang
- Shanghai MicroPort Medical (Group) Co., Ltd, Shanghai, China
| | - Ping Liu
- School of Materials Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Hongyan Jiang
- Shanghai MicroPort Medical (Group) Co., Ltd, Shanghai, China
| | - Zhaohua Chang
- Shanghai MicroPort Medical (Group) Co., Ltd, Shanghai, China
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4
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Stawicki S, Sims C, Sharma R, Weger N, Truitt M, Cipolla J, Schrag S, Lorenzo M, Chaar MEL, Torigian D, Kim P, Sarani B. Vena Cava Filters: A Synopsis of Complications and Related Topics. J Vasc Access 2018. [DOI: 10.1177/112972980800900204] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Deep venous thrombosis and pulmonary embolism constitute common preventable causes of morbidity and mortality. The incidence of venous thromboembolism (VTE) continues to increase. Standard anticoagulation therapy may reduce the risk of fatal PE by 75% and that of recurrent VTE by over 90%. For patients who are not candidates for anticoagulation, a vena cava filter (VCF) may be beneficial. Despite a good overall safety record, significant complications related to VCF are occasionally seen. This review discusses both procedural and non-procedural complications associated with VCF placement and use. We will also discuss VCF use in the settings of pregnancy, malignancy, and the clinical need for more than one filter.
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Affiliation(s)
- S.P. Stawicki
- Department of Surgery, Division of Critical Care, Trauma and Burns, The Ohio State University Medical Center, Columbus, OH - USA
- OPUS 12 Foundation, Inc, King of Prussia, PA - USA
| | - C.A. Sims
- Department of Surgery, Division of Traumatology and Surgical Critical Care, University of Pennsylvania School of Medicine, Philadelphia, PA - USA
- OPUS 12 Foundation, Inc, King of Prussia, PA - USA
| | - R. Sharma
- Department of Surgery, Easton Hospital, Easton, PA - USA
- OPUS 12 Foundation, Inc, King of Prussia, PA - USA
| | - N.S. Weger
- Beth Israel Medical Center, Newark, NJ - USA
- OPUS 12 Foundation, Inc, King of Prussia, PA - USA
| | - M. Truitt
- Department of Surgery, Methodist Hospital, Dallas, TX - USA
- OPUS 12 Foundation, Inc, King of Prussia, PA - USA
| | - J. Cipolla
- St. Luke's Regional Resource Level I Trauma Center, Bethlehem, PA - USA
- OPUS 12 Foundation, Inc, King of Prussia, PA - USA
| | - S.P. Schrag
- Department of Surgery, Division of Trauma and Surgical Critical Care, Vanderbilt University School of Medicine, Nashville, TN - USA
- OPUS 12 Foundation, Inc, King of Prussia, PA - USA
| | - M. Lorenzo
- Department of Surgery, Methodist Hospital, Dallas, TX - USA
- OPUS 12 Foundation, Inc, King of Prussia, PA - USA
| | - M. EL Chaar
- Department of Surgery, Methodist Hospital, Dallas, TX - USA
- OPUS 12 Foundation, Inc, King of Prussia, PA - USA
| | - D.A. Torigian
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA - USA
| | - P.K. Kim
- Department of Surgery, Division of Traumatology and Surgical Critical Care, University of Pennsylvania School of Medicine, Philadelphia, PA - USA
- OPUS 12 Foundation, Inc, King of Prussia, PA - USA
| | - B. Sarani
- Department of Surgery, Division of Traumatology and Surgical Critical Care, University of Pennsylvania School of Medicine, Philadelphia, PA - USA
- OPUS 12 Foundation, Inc, King of Prussia, PA - USA
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5
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Dalla Vestra M, Grolla E, Bonanni L, Pesavento R. Are too many inferior vena cava filters used? Controversial evidences in different clinical settings: a narrative review. Intern Emerg Med 2018; 13:145-154. [PMID: 27873159 DOI: 10.1007/s11739-016-1575-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 11/12/2016] [Indexed: 10/20/2022]
Abstract
The use of inferior vena cava filters to prevent pulmonary embolism is increasing mainly because of indications that appear to be unclearly codified and recommended. The evidence supporting this approach is often heterogeneous, and mainly based on observational studies and consensus opinions, while the insertion of an IVC filter exposes patients to the risk of complications and increases health care costs. Thus, several proposed indications for an IVC filter placement remain controversial. We attempt to review the proof on the efficacy and safety of IVC filters in several "special" clinical settings, and assess the robustness of the available evidence for any specific indication to place an IVC filter.
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Affiliation(s)
- Michele Dalla Vestra
- Department of Internal Medicine, Angiology Unit, Ospedale dell'Angelo, Via Paccagnella 11, 30174, Mestre (VE), Italy.
| | | | - Luca Bonanni
- Department of Internal Medicine, Ospedale dell'Angelo, Mestre (VE), Italy
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6
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Tse G, Cleveland T, Goode S. Ten-year experience of retrievable inferior vena cava filters in a tertiary referral center. Diagn Interv Radiol 2017; 23:144-149. [PMID: 28093377 DOI: 10.5152/dir.2016.16022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE A significant proportion of patients undergoing surgery have an increased incidence of acute pulmonary embolus (PE). We analyzed all patients who had a retrievable inferior vena cava (IVC) filter placed preoperatively for PE prophylaxis and investigated the long-term outcomes of the patients who did not have their filter removed. METHODS Patients who underwent retrievable IVC filter insertion and attempted removal were identified from the radiology information systems database in a large tertiary referral university teaching hospital. Results of all clinical investigations (including computed tomography, magnetic resonance imaging, ultrasonography, and plain radiography) while the IVC filters were in situ were reviewed. RESULTS In total, 393 retrievable IVC filters were inserted, 254 with the indication of preoperative thromboembolic prophylaxis. Recurrent PE was reported in five patients (1.9%) despite the IVC filter. Of the 254 retrievable filters inserted prior to surgery, an attempt at retrieval was made in 168 filters (66.1%). Successful retrieval at the first attempt occurred in 143 cases (85.1%), while 25 cases failed or were aborted (14.9%). No attempt at retrieval was made in 86 (33.9%) patients and a significant proportion of these patients had undergone cancer surgery (P < 0.0107). In those patients where there was no attempt at retrieval, there was an association between cancer surgery and a shorter absolute survival time (P < 0.0001). CONCLUSION The majority of attempted filter retrievals were successful, and a proportion of nonretrieved IVC filters are accounted for in patients who underwent cancer surgery and ultimately died with the filter in situ. A departmental protocol is recommended to ensure the filter is removed where appropriate and possible.
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Affiliation(s)
- George Tse
- Department of Radiology, Northern General Hospital, Sheffield, UK.
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7
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Kang J, Ko HK, Shin JH, Ko GY, Jo KW, Huh JW, Oh YM, Lee SD, Lee JS. Practice patterns of retrievable inferior vena cava filters and predictors of filter retrieval in patients with pulmonary embolism. Vasc Med 2017; 22:512-517. [PMID: 28879803 DOI: 10.1177/1358863x17726596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Retrievable inferior vena cava (IVC) filters are increasingly used in patients with venous thromboembolism (VTE) who have contraindications to anticoagulant therapy. However, previous studies have shown that many retrievable filters are left permanently in patients. This study aimed to identify the common indications for IVC filter insertion, the filter retrieval rate, and the predictive factors for filter retrieval attempts. To this end, a retrospective cohort study was performed at a tertiary care center in South Korea between January 2010 and May 2016. Electronic medical charts were reviewed for patients with pulmonary embolism (PE) who underwent IVC filter insertion. A total of 439 cases were reviewed. The most common indication for filter insertion was a preoperative/procedural aim, followed by extensive iliofemoral deep vein thrombosis (DVT). Retrieval of the IVC filter was attempted in 44.9% of patients. The retrieval success rate was 93.9%. History of cerebral hemorrhage, malignancy, and admission to a nonsurgical department were the significant predictive factors of a lower retrieval attempt rate in multivariate analysis. With the increased use of IVC filters, more issues should be addressed before placing a filter and physicians should attempt to improve the filter retrieval rate.
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Affiliation(s)
- Jieun Kang
- 1 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Heung-Kyu Ko
- 2 Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Hoon Shin
- 2 Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Gi-Young Ko
- 2 Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyung-Wook Jo
- 1 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin Won Huh
- 1 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yeon-Mok Oh
- 1 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Do Lee
- 1 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Seung Lee
- 1 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,3 Department of Pulmonary and Critical Care Medicine, Center for Pulmonary Hypertension and Venous Thrombosis, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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8
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Lim JH, Lee WY, Ra YJ, Jeong JH, Park BS, Ko HH. Extravascular Migration of a Fractured Inferior Vena Cava Filter Strut. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2017; 50:224-227. [PMID: 28593162 PMCID: PMC5460973 DOI: 10.5090/kjtcs.2017.50.3.224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/20/2016] [Accepted: 10/24/2016] [Indexed: 11/26/2022]
Abstract
A 20-year-old man presented with a femur fracture and epidural hemorrhage (EDH) following a fall. One month after fracture surgery, swelling developed in both legs, and he was diagnosed as having a deep-vein thrombosis and pulmonary embolism. A retrievable inferior vena cava filter (IVCF) was inserted, because EDH is a contraindication to anticoagulants. Four months later, he complained of abdominal pain, and a computed tomography scan showed a fractured IVCF strut. After percutaneous removal failed 3 times, the IVCF was surgically removed by orthopedists using a portable image intensifier without cardiopulmonary bypass.
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Affiliation(s)
- Jung Hyeon Lim
- Department of Cardiothoracic Surgery, Hanllym University Sacred Heart Hospital, Hanllym University College of Medicine
| | - Weon Yong Lee
- Department of Cardiothoracic Surgery, Hanllym University Sacred Heart Hospital, Hanllym University College of Medicine
| | - Yong Joon Ra
- Department of Cardiothoracic Surgery, Hanllym University Sacred Heart Hospital, Hanllym University College of Medicine
| | - Jae Han Jeong
- Department of Cardiothoracic Surgery, Chosun University Hospital, Chosun University College of Medicine
| | - Bong Suk Park
- Department of Cardiothoracic Surgery, Hanllym University Sacred Heart Hospital, Hanllym University College of Medicine
| | - Ho Hyun Ko
- Department of Cardiothoracic Surgery, Hanllym University Sacred Heart Hospital, Hanllym University College of Medicine
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9
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Abstract
Optional vena cava filters can used to provide either short-term or permanent protection from pulmonary embolism. These devices have recently become available for clinical use in the United States. However, there remains a paucity of data about these devices and their outcomes. This article reviews current and future devices, the rationale behind non-permanent caval filtration, and the generally accepted guidelines for their clinical application.
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Affiliation(s)
- John A. Kaufman
- *Dotter Institute/Oregon Health & Science University, Portland, OR
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10
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El Sayed HF, Kougias P, Zhou W, Lin PH. Utility of Retrievable Vena Cava Filters and Mechanical Thrombectomy in the Endovascular Management of Acute Deep Venous Thrombosis. Vascular 2016; 14:305-12. [PMID: 17038301 DOI: 10.2310/6670.2006.00046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Endovascular interventions of symptomatic deep venous thrombosis (DVT) using various therapeutic modalities, such as thrombolysis, mechanical thrombectomy, and inferior vena cava (IVC) filter placement, have received increased focus owing in part to advances in catheter-based interventional technologies. Although systemic anticoagulation remains the primary treatment modality in DVT, catheter-based interventions can provide rapid removal of large thrombus burden and possibly preserve venous valvular function in patients with symptomatic DVT. This article reviews current endovascular treatment strategies for acute DVT. Specifically, the utility of mechanical thrombectomy along with various temporary IVC filters in the setting of DVT is examined. Lastly, an illustrative case of acute DVT that was treated with endovascular intervention with IVC filter placement is presented.
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Affiliation(s)
- Hosam F El Sayed
- Division of Vascualr and Endovascular Therapy, Micheal E. DeBakey Department of Surgery, Baylor College of Medicine, Micheal E. DeBakey VA Medical Center, Houston, TX 77030, USA
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11
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Pokharel S, Bartholomew C, Zau Z. Duodenal perforation by an inferior vena cava filter with staphylococcal bacteremia: a case report. J Med Case Rep 2016; 10:111. [PMID: 27145864 PMCID: PMC4857254 DOI: 10.1186/s13256-016-0901-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 04/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inferior vena cava filter complications can range from dislodgement to perforation. Patients who present with concomitant bacteremia have rarely been reported. Persistent bacteremia usually results from direct bacterial seeding from a source other than perforation of surrounding viscus. It is unclear if the risk of perforation is higher in patients who are bacteremic due to other causes. CASE PRESENTATION We report an interesting case of a 67-year-old white woman who presented with fever, chills, and right upper quadrant abdominal pain. Her blood cultures were positive for methicillin-sensitive Staphylococcus aureus with no obvious source. Upon further investigation, she was found to have an inferior vena cava filter perforating her duodenum. The cause of her abdominal pain was explained by the inferior vena cava filter penetrating the duodenum; however, the source of bacteremia could not be ascertained. The inferior vena cava filter was removed successfully, and she was discharged on an intravenous antibiotic. Her symptoms resolved soon after the filter was removed. CONCLUSIONS The use of inferior vena cava filters has increased significantly in recent years. This is likely due to their wider availability and safer placement techniques. With increasing use, the complications arising from these filters have been on the rise as well. It is very important for clinicians to be aware of these complications to avoid delays in diagnosis and patient care.
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Affiliation(s)
- Sunil Pokharel
- Department of Medicine, Albany Medical Center, 47 New Scotland Avenue, Mail Code 17, Albany, NY, 12208, USA.
| | - Catherine Bartholomew
- Department of Gastroenterology, Albany Medical Center, 47 New Scotland Avenue, Mail Code 48, Albany, NY, 12208, USA
| | - Zing Zau
- Department of Medicine, Albany Medical Center, 47 New Scotland Avenue, Mail Code 17, Albany, NY, 12208, USA
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12
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Tsui B, An T, Moon E, King R, Wang W. Retrospective Review of 516 Implantations of Option Inferior Vena Cava Filters at a Single Health Care System. J Vasc Interv Radiol 2016; 27:345-53. [DOI: 10.1016/j.jvir.2015.11.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 11/24/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022] Open
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Montgomery JP, Kaufman JA. Inferior Vena Cava Filters: Indications, Outcomes, and Evidence. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2015; 17:401. [PMID: 26246444 DOI: 10.1007/s11936-015-0401-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OPINION STATEMENT Filter technology seems relatively stable, although absorbable devices are an area of investigational interest. The indications for filter placement remain controversial, with wide variations in adherence to guidelines, and relatively poor quality of data about the specific prophylactic indications of trauma or bariatric surgery. The outcomes of filters are not well-defined despite widespread clinical use, and good data remains difficult to obtain. Several larger database and institutional retrospective studies support the notions that while filters prevent pulmonary embolism, they may be associated with venous thrombotic complications. Some subsets of cancer patients may be at increased risk of these complications, but whether the filter or the underlying hypercoagulable state is the cause is not clear. Lastly, although the benefits of filter retrieval are widely assumed (but not proven), filter retrieval rates remain lower than expected. The single most influential factor in improving filter retrieval rates is dedicated follow-up with intent to retrieve the filter.
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Affiliation(s)
- Jennifer P Montgomery
- Dotter Interventional Institute, Oregon Health and Science University Hospital, 3181 SW Sam Jackson Park Dr., Portland, OR, 97239, USA,
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14
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Eggers MD, McArthur MJ, Figueira TA, Abdelsalam ME, Dixon KP, Pageon LR, Wallace MJ, Huang SY. Pilot in vivo study of an absorbable polydioxanone vena cava filter. J Vasc Surg Venous Lymphat Disord 2015; 3:409-420. [PMID: 26992619 DOI: 10.1016/j.jvsv.2015.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 03/01/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objectives of this study were to evaluate tensile strength retention of polydioxanone as a function of time in a swine venous system and to assess the feasibility of an absorbable inferior vena cava (IVC) filter made from polydioxanone in a pilot swine study. METHODS Twenty strands (60 cm each) of size 1 polydioxanone absorbable suture (Ethicon, Somerville, NJ) were placed in the central venous system of domestic swine. Strands were harvested at weekly intervals during 10 weeks for tensile strength testing. Results were compared with control samples obtained from an in vitro engineered circulation system containing sodium phosphate buffer solution. Three IVC filters braided from polydioxanone suture were also catheter deployed in three swine to assess absorbable IVC filter feasibility. RESULTS Polydioxanone retained 82% tensile strength in vitro vs 79% in vivo at 35 days (P > .22), the desired prophylactic duration. For IVC filters made from polydioxanone, technical success of placement was achieved in all three filters deployed (100%). Autologous thrombus deployed inferior to the filter remained trapped in the filter until thrombus resorption, with no evidence of pulmonary emboli on follow-up computed tomography. There were no instances of caval penetration, filter-induced IVC thrombosis, filter migration, or tilt >15 degrees with imaging and clinical follow-up carried out to 32 weeks. CONCLUSIONS Strength retention of polydioxanone suture placed in the venous system of swine is similar to earlier in vitro studies out to 10 weeks (P > .06 for all weeks) and is more than sufficient (8.20 ± 0.37 kg mean load at break for size 1) to trap thrombus. Pilot animal study suggests that an absorbable polydioxanone IVC filter can be catheter deployed to capture and to hold iatrogenically administered autologous thrombus through resorption.
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Affiliation(s)
- Mitchell D Eggers
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Tex.
| | - Mark J McArthur
- Department of Veterinary Medicine and Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Tomas A Figueira
- Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Mohamed E Abdelsalam
- Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Katherine P Dixon
- Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Laura R Pageon
- Department of Veterinary Medicine and Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Michael J Wallace
- Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Steven Y Huang
- Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex
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15
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Stavropoulos SW, Ge BH, Mondschein JI, Shlansky-Goldberg RD, Sudheendra D, Trerotola SO. Retrieval of Tip-embedded Inferior Vena Cava Filters by Using the Endobronchial Forceps Technique: Experience at a Single Institution. Radiology 2015; 275:900-7. [DOI: 10.1148/radiol.14141420] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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16
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Abstract
We present a case of pericardial effusion due to embolization of a fragment of an inferior vena cava (IVC) filter, with subsequent perforation of the right ventricle. This is a rare and unexpected cause of pericardial effusion. Fracture or embolization of IVC filters is a relatively uncommon complication, but these events may have serious clinical implications. Although IVC filters are often placed with the intent of removal, the device in many patients is never removed. The long-term implications of IVC filter placement must be kept in mind when making decisions about device placement and subsequent removal.
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17
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Development of venous thromboembolism (VTE) in patients undergoing surgery for brain tumors: Results from a single center over a 10year period. J Clin Neurosci 2015; 22:519-25. [DOI: 10.1016/j.jocn.2014.10.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 10/01/2014] [Indexed: 11/30/2022]
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18
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Haga M, Hosaka A, Miyahara T, Hoshina K, Shigematsu K, Watanabe T. Penetration of an inferior vena cava filter into the aorta. Ann Vasc Dis 2014; 7:413-6. [PMID: 25593628 DOI: 10.3400/avd.cr.14-00066] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 08/23/2014] [Indexed: 11/13/2022] Open
Abstract
Transvenous placement of inferior vena cava (IVC) filters is commonly performed in selected patients with deep venous thrombosis and pulmonary embolism. However, filter placement is sometimes associated with serious complications. A common complication is asymptomatic perforation of the IVC and penetration of adjacent organs by the filter. Here, we report a case of an 83-year-old man whose prophylactic IVC filter penetrated the aorta. The patient was closely followed without surgical intervention for more than a year, and no additional complications were observed.
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Affiliation(s)
- Makoto Haga
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
| | - Akihiro Hosaka
- Current institution: Department of Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Takuya Miyahara
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
| | - Katsuyuki Hoshina
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
| | - Kunihiro Shigematsu
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
| | - Toshiaki Watanabe
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
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19
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Jia W, Liu J, Tian X, Jiang P. Tempofilter II implantation in patients with lower extremity fractures and proximal deep vein thrombosis. Diagn Interv Radiol 2014; 20:245-50. [PMID: 24675164 DOI: 10.5152/dir.2013.13289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE We aimed to examine the efficacy and safety of Tempofilter II (B. Braun, Melsungen, Germany) implantation to prevent pulmonary embolism in patients with lower-extremity fractures and proximal deep vein thrombosis (DVT). MATERIALS AND METHODS The records of patients with lower limb fractures and proximal DVT who were implanted with Tempofilter II devices from May 2004 to August 2009 were reviewed. Data collected included success rate, occurrence of pulmonary embolism, retrieval rate, and complications. RESULTS A total of 176 eligible patients, including 129 males (73.3%) and 47 females (26.7%) with a median age of 42.0 years (interquartile range [IQR], 34.0-52.0 years) were included in the study. Filters were successfully implanted in 174 patients (98.9%). One patient experienced a pulmonary embolism after implantation and died. Filters were removed without complications in all other patients. Median filter implantation time was 27 days (IQR, 25.0-29.0 days). Visible organized thrombi were present on the surface of 144 (82.8%) of filters after removal, and the diameter of most thrombi (n=124) ranged from 0.5 to 1.0 cm. Filters migrated <2 cm in 104 patients (59.8%) and ≥ 2 cm in five patients (2.9%). In these five cases, three filters migrated into the right atrium and two migrated to the orifice of the renal veins. CONCLUSION Tempofilter II is safe and may be useful in cases of lower extremity fracture with proximal DVT for the prevention of pulmonary embolism. The filter is easily placed and retrieved, and associated with minimal complications.
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Affiliation(s)
- Wei Jia
- From the Department of Vascular Surgery Beijing Jishuitan Hospital, Beijing, China.
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20
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Molvar C. Inferior vena cava filtration in the management of venous thromboembolism: filtering the data. Semin Intervent Radiol 2013; 29:204-17. [PMID: 23997414 DOI: 10.1055/s-0032-1326931] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Venous thromboembolism (VTE) is a common cause of morbidity and mortality. This is especially true for hospitalized patients. Pulmonary embolism (PE) is the leading preventable cause of in-hospital mortality. The preferred method of both treatment and prophylaxis for VTE is anticoagulation. However, in a subset of patients, anticoagulation therapy is contraindicated or ineffective, and these patients often receive an inferior vena cava (IVC) filter. The sole purpose of an IVC filter is prevention of clinically significant PE. IVC filter usage has increased every year, most recently due to the availability of retrievable devices and a relaxation of thresholds for placement. Much of this recent growth has occurred in the trauma patient population given the high potential for VTE and frequent contraindication to anticoagulation. Retrievable filters, which strive to offer the benefits of permanent filters without time-sensitive complications, come with a new set of challenges including methods for filter follow-up and retrieval.
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21
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Rajasekhar A, Streiff MB. Vena cava filters for management of venous thromboembolism: A clinical review. Blood Rev 2013; 27:225-41. [DOI: 10.1016/j.blre.2013.07.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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22
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Van Ha TG, Kang L, Lorenz J, Zangan S, Navuluri R, Straus C, Funaki B. Difficult OptEase Filter Retrievals After Prolonged Indwelling Times. Cardiovasc Intervent Radiol 2013; 36:1139-43. [DOI: 10.1007/s00270-013-0619-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 03/13/2013] [Indexed: 11/25/2022]
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23
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Presentation and Treatment Outcomes of Patients With Symptomatic Inferior Vena Cava Filters. Ann Vasc Surg 2013; 27:84-8. [DOI: 10.1016/j.avsg.2012.06.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 06/04/2012] [Accepted: 06/27/2012] [Indexed: 11/23/2022]
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24
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Imberti D, Ageno W, Dentali F, Donadini M, Manfredini R, Gallerani M. Retrievable vena cava filters: a clinical review. J Thromb Thrombolysis 2012; 33:258-66. [PMID: 22240968 DOI: 10.1007/s11239-011-0671-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism (PE), is a major cause of morbidity and mortality. Parenteral anticoagulant treatment with full-dose unfractioned heparin, low-molecular-weight-heparin, or fondaparinux, followed by oral treatment with the vitamin K antagonists, is recommended for the majority of patients. However, in the presence of contraindications to anticoagulant treatment, bleeding complications during antithrombotic treatment, or VTE recurrences despite optimal anticoagulation, interruption of the inferior vena cava with a filter is a potential option aimed to prevent life-threatening PE. Currently, the vast majority of filters implanted worldwide are of the permanent type, but their use is associated with a number of long term complications. Non-permanent filters represent an important alternative, and in particular retrievable filters are an attractive option because they may be either left in place permanently or safely retrieved after a quite long period when they become unnecessary. In this review, we summarize the currently available literature regarding retrievable vena cava filters and we discuss current evidences on their efficacy and safety. Moreover, the appropriate indications for their use in daily clinical practice are reviewed.
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Affiliation(s)
- Davide Imberti
- Department of Internal Medicine, Piacenza Hospital, Via Taverna 49, 29121 Piacenza, Italy.
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25
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In Vitro Analysis of Polymer Candidates for the Development of Absorbable Vascular Filters. J Vasc Interv Radiol 2012; 23:1023-30. [DOI: 10.1016/j.jvir.2012.05.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 04/27/2012] [Accepted: 05/08/2012] [Indexed: 11/20/2022] Open
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26
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Kidane B, Madani AM, Vogt K, Girotti M, Malthaner RA, Parry NG. The use of prophylactic inferior vena cava filters in trauma patients: a systematic review. Injury 2012; 43:542-7. [PMID: 22386925 DOI: 10.1016/j.injury.2012.01.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Revised: 12/23/2011] [Accepted: 01/20/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Pulmonary embolisms (PE) are an often preventable cause of late morbidity and mortality after trauma. Although there is evidence for the use of therapeutic inferior vena cava (IVC) filters (defined as IVC filters implanted in those with proven deep venous thrombosis [DVT] in order to prevent PE), there is not as much evidence to support the use of prophylactic IVC filters. Thus, we undertook a systematic review of the literature to assess the following in prophylactic IVC filters: efficacy in PE reduction, prevalence of filter-related complications and the indications for use. MATERIALS AND METHODS After screening 249 studies, 24 studies met inclusion criteria for qualitative synthesis. RESULTS Overall, the literature is supportive of the use of prophylactic IVC filters in high-risk poly-trauma patients who may have contraindications to DVT prophylaxis. Filter-associated complications are uncommon and, when they do occur, tend to be of limited clinical significance. Limited data, mostly in the form of case series, supports a reduction in PE and PE-related mortality. There has been increasing use of retrievable filters as well as the ability to safely retrieve them at longer intervals. CONCLUSION Despite the addition of a few matched-control studies, the literature is still plagued by a lack of high quality data, and therefore the true efficacy of prophylactic IVC filters for prevention of PE in trauma patients remains unclear. Further studies are required to determine the true role of prophylactic IVC filters in trauma patient.
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Affiliation(s)
- Biniam Kidane
- Division of General Surgery, Department of Surgery, University of Western Ontario, London, Ontario, Canada.
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27
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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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28
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Imberti D, Ageno W, Manfredini R, Fabbian F, Salmi R, Duce R, Gallerani M. Interventional treatment of venous thromboembolism: a review. Thromb Res 2011; 129:418-25. [PMID: 22119500 DOI: 10.1016/j.thromres.2011.11.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 10/17/2011] [Accepted: 11/02/2011] [Indexed: 02/06/2023]
Abstract
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most common cardiovascular disease after coronary artery disease and cerebrovascular disease and is responsible for significant morbidity and mortality in the general population. Full dose anticoagulation is the standard therapy for VTE, both for the acute and the long-term phase. The latest guidelines of the American College of Chest Physicians recommend treatment with a full-dose of unfractioned heparin (UFH), low-molecular-weight-heparin (LMWH), fondaparinux, vitamin K antagonist (VKA) or thrombolysis for most patients with objectively confirmed VTE. Catheter-guided thrombolysis and trombosuction are interventional approaches that should be used only in selected populations; interruption of the inferior vena cava (IVC) with a filter can be performed to prevent life-threatening PE in patients with VTE and contraindications to anticoagulant treatment, bleeding complications during antithrombotic treatment, or VTE recurrences despite optimal anticoagulation. In this review we summarize the currently available literature regarding interventional approaches for VTE treatment (vena cava filters, catheter-guided thrombolysis, thrombosuction) and we discuss current evidences on their efficacy and safety. Moreover, the appropriate indications for their use in daily clinical practice are reviewed.
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Affiliation(s)
- Davide Imberti
- Department of Internal Medicine, Piacenza Hospital, Italy.
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29
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Bathla L, Panwar A, Fitzgibbons RJ, Balters M. Duodenocaval Fistula From Inferior Vena Cava Filter Penetration Masquerading as Lower Gastrointestinal Bleeding. Ann Vasc Surg 2011; 25:1140.e7-11. [DOI: 10.1016/j.avsg.2011.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Revised: 03/14/2011] [Accepted: 03/27/2011] [Indexed: 11/28/2022]
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30
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Johnson C, Alomari AI, Chaudry G. Detachment of introducer sheath radiopaque marker during retrieval of G2 filter. Cardiovasc Intervent Radiol 2011; 34:431-4. [PMID: 21170531 DOI: 10.1007/s00270-010-0064-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Craig Johnson
- Division of Pediatric Interventional Radiology, Department of Imaging, Medical College of Wisconsin-Children's Hospital of Wisconsin, Wauwatosa, WI 53226, USA.
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31
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Affiliation(s)
- Thuong G Van Ha
- Department of Radiology, University of Chicago, Chicago, IL, USA.
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32
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Abstract
Inferior vena caval filters have been shown to be effective in the prevention of pulmonary embolism, with low morbidity and mortality associated with their implantation. Awareness of potential complications can further decrease the risk of filter placement and lead to early detection and management of complications to improve clinical outcomes. The purpose of this article is to review the procedure-related and delayed complications associated with inferior vena caval filters.
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Affiliation(s)
- Thuong G Van Ha
- Department of Radiology, Section of Vascular and Interventional Radiology, University of Chicago Hospitals, Chicago, Illinois
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33
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White SB, Stavropoulos SW. Retrieval of a wall-embedded recovery inferior vena cava filter using rigid bronchoscopy forceps. Semin Intervent Radiol 2011; 24:15-9. [PMID: 21326730 DOI: 10.1055/s-2007-971191] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Optional inferior vena cava (IVC) filters are an attractive option to help prevent pulmonary embolism because these filters can be retrieved when the risk for thromboembolic events has passed. Retrieval of IVC filters can be difficult if the filter tilts and its tip becomes embedded into the wall of the IVC. A case is presented in which rigid bronchoscopy forceps were used to retrieve a filter that had become embedded in the wall of the IVC.
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Affiliation(s)
- Sarah B White
- Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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34
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Radiology-led Follow-up System for IVC Filters: Effects on Retrieval Rates and Times. Cardiovasc Intervent Radiol 2011; 35:309-15. [DOI: 10.1007/s00270-011-0198-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Accepted: 02/15/2011] [Indexed: 10/18/2022]
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35
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Shaw CM, Scorza LB, Waybill PN, Singh H, Lynch FC. Optional Vena Cava Filter Use in the Elderly Population. J Vasc Interv Radiol 2011; 22:824-8. [DOI: 10.1016/j.jvir.2011.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2010] [Revised: 02/27/2011] [Accepted: 03/10/2011] [Indexed: 11/17/2022] Open
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36
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Aziz F, Comerota AJ. Inferior Vena Cava Filters. Ann Vasc Surg 2010; 24:966-79. [DOI: 10.1016/j.avsg.2010.03.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 03/21/2010] [Indexed: 10/19/2022]
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37
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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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38
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Martin MJ, Blair KS, Curry TK, Singh N. Vena Cava Filters: Current Concepts and Controversies for the Surgeon. Curr Probl Surg 2010; 47:524-618. [DOI: 10.1067/j.cpsurg.2010.03.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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39
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Inferior Vena Cava Filters in Trauma Patients: Efficacy, Morbidity, and Retrievability. ACTA ACUST UNITED AC 2010; 68:899-903. [PMID: 20386285 DOI: 10.1097/ta.0b013e3181d3cbdc] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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40
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Mission JF, Kerlan RK, Tan JH, Fang MC. Rates and predictors of plans for inferior vena cava filter retrieval in hospitalized patients. J Gen Intern Med 2010; 25:321-5. [PMID: 20087675 PMCID: PMC2842553 DOI: 10.1007/s11606-009-1227-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 11/17/2009] [Accepted: 12/10/2009] [Indexed: 11/27/2022]
Abstract
BACKGROUND Use of inferior vena cava (IVC) filters has been increasing over time. However, because of the increased risk of deep vein thrombosis with permanent filters, placement of retrievable filters has been recommended. Little is known about the factors associated with planned retrieval of IVC filters. OBJECTIVE To describe rates and predictors of plans to retrieve IVC filters in hospitalized patients. DESIGN We identified all IVC filter placements from 2001-2006 at an academic medical center and reviewed medical charts to obtain data about patient characteristics, filter retrieval plans, and retrieval success rates. Multivariable logistic regression was used to identify independent predictors of planned filter retrieval in patients with retrievable filters. RESULTS Out of 240 patients who underwent placement of retrievable IVC filters, only 73 (30.4%) had documented plans for filter retrieval. Factors associated with lower rates of planned filter retrieval included a history of cancer [adjusted odds ratio (OR) and 95% confidence interval 0.2 (0.1-0.5)] and not being discharged on anticoagulants [OR 0.1 (0.1-0.3)]. In addition, 36 (21.6%) of patients without retrieval plans had no contraindications to retrieval. Of the 62 patients who underwent attempted filter retrieval, 25.8% of filters could not be successfully removed. CONCLUSIONS Only 30.4% of patients who underwent placement of a retrievable IVC filter had documented plans for filter removal. Although most patients had justifiable reasons for filter retention, 21.6% of patients had no clear contraindications to filter removal. Efforts to improve rates of filter retrieval in appropriate patients may help reduce the long-term complications of IVC filters.
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Affiliation(s)
- John F Mission
- The University of California San Francisco School of Medicine, San Francisco, CA, USA
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41
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Kozak J, Köcher M, Thomas RP, Cerna M, Burval S. RETRIEVAL OF "RECOVERY IVC FILTER(TM)" AFTER 383 DAYS. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2009; 153:293-6. [DOI: 10.5507/bp.2009.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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42
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Technical Success and Safety of Retrieval of the G2 Filter in a Prospective, Multicenter Study. J Vasc Interv Radiol 2009; 20:1449-53. [DOI: 10.1016/j.jvir.2009.08.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Revised: 08/09/2009] [Accepted: 08/13/2009] [Indexed: 11/23/2022] Open
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43
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Institutional protocol improves retrievable inferior vena cava filter recovery rate. Surgery 2009; 146:809-14; discussion 814-6. [DOI: 10.1016/j.surg.2009.06.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2009] [Accepted: 06/12/2009] [Indexed: 11/17/2022]
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44
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Murphy EH, Johnson ED, Kopchok GE, Fogarty TJ, Arko FR. Crux vena cava filter. Expert Rev Med Devices 2009; 6:477-85. [PMID: 19751120 DOI: 10.1586/erd.09.25] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Inferior vena cava filters are widely accepted for pulmonary embolic prophylaxis in high-risk patients with contraindications to anticoagulation. While long-term complications have been associated with permanent filters, retrievable filters are now available and have resulted in the rapid expansion of this technology. Nonetheless, complications are still reported with optional filters. Furthermore, device tilting and thrombus load may prevent retrieval in up to 30% of patients, thereby eliminating the benefits of this technology. The Crux vena cava filter is a novel, self-centering, low-profile filter that is designed for ease of delivery, retrievability and improved efficacy while limiting fatigue-related device complications. This device has been proven safe and user-friendly in an ovine model and has recently been implanted in human subjects.
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Affiliation(s)
- Erin H Murphy
- General Surgery Resident, University of Texas Southwestern Medical Center, Dallas, TX 75903, USA
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45
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Comparison of the Recovery and G2 Filter as Retrievable Inferior Vena Cava Filters. J Vasc Interv Radiol 2009; 20:1193-9. [DOI: 10.1016/j.jvir.2009.05.037] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2008] [Revised: 03/31/2009] [Accepted: 05/28/2009] [Indexed: 11/24/2022] Open
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46
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47
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Abstract
Vena cava filters were developed as a method of preventing pulmonary embolism (PE) in patients with venous thromboembolism (VTE) at risk for bleeding from therapeutic anticoagulation. However, the long-term complications of filter placement, such as caval thrombosis, have mitigated some of the benefits, particularly in those patients with only a temporary contraindication to anticoagulation. Retrievable filters were designed to avoid the long-term risks of a permanent filter while still providing short-term protection against PE. As a result, their use has expanded from patients with known thrombosis to those without VTE who are at high risk for developing PE. In this review, we discuss the different types of retrievable filters, indications for their placement, complications that can occur during and after placement, and their use as prophylaxis in surgical patients. Although the use of retrievable filters in patients with known VTE is clear, further studies are needed to establish their prophylactic efficacy in the surgical patient. Until this evidence is available, we recommend that retrievable filters should be used only in patients with acute VTE who are at risk for recurrent thromboembolism and have a transient risk for bleeding.
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Affiliation(s)
- Marianne Tschoe
- Division of Hospital Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
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48
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Charles HW, Black M, Kovacs S, Gohari A, Arampulikan J, McCann JW, Clark TW, Bashar M, Steiger D. G2 Inferior Vena Cava Filter: Retrievability and Safety. J Vasc Interv Radiol 2009; 20:1046-51. [DOI: 10.1016/j.jvir.2009.03.046] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2008] [Revised: 03/30/2009] [Accepted: 03/30/2009] [Indexed: 10/20/2022] Open
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49
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Endovascular Treatment Options in the Management of Lower Limb Deep Venous Thrombosis. Cardiovasc Intervent Radiol 2009; 32:861-76. [DOI: 10.1007/s00270-009-9662-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2008] [Revised: 06/28/2009] [Accepted: 06/30/2009] [Indexed: 12/17/2022]
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Hoppe H. Optional vena cava filters: indications, management, and results. DEUTSCHES ARZTEBLATT INTERNATIONAL 2009; 106:395-402. [PMID: 19623306 DOI: 10.3238/arztebl.2009.0395] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Accepted: 12/22/2008] [Indexed: 11/27/2022]
Abstract
BACKGROUND When anticoagulation is contraindicated or ineffective, optional vena cava filters can be used to prevent pulmonary embolism. These devices can be removed within a defined period of time or can remain in the vena cava permanently. METHODS The status of optional vena cava filters was studied by a review of the relevant literature found in a selective Medline search from 2000 to 2008, including a Cochrane review and published guidelines. RESULTS Optional vena cava filter can be removed up to 20 weeks or even longer after insertion (depending on the filter model) in a small interventional radiological procedure if therapeutic anticoagulation has been achieved or the patient is no longer at risk for venous thromboembolism. Current studies show comparable results for optional filters and permanent filters, but there have not yet been any prospective studies comparing the two filter types. CONCLUSIONS Optional vena cava filters are an important addition to the management of venous thromboembolic disease. As only limited data are available to date, the use of optional filters should be considered on an individual case basis.
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Affiliation(s)
- Hanno Hoppe
- Institut für Diagnostische, Interventionelle und Pädiatrische Radiologie, Inselspital, Universitätsspital Bern, Schweiz.
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