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Qin L, Wang K, Tian F, Xue T, Jia Z, Li S. A change in strategy for filter choice leads to improved filter retrieval rates. Heart Vessels 2024; 39:640-645. [PMID: 38310515 DOI: 10.1007/s00380-024-02371-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/24/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVE To assess whether a new strategy for the choice of inferior vena cava filter placed would improve filter retrieval rates at our institution. METHODS Consecutive patients who underwent retrievable filter placement for temporary embolic protection between January 2021 and January 2023 were considered for study inclusion. Risk factors for nonretrieval of short-term filters were identified in patients receiving filters between January 2021 and January 2022 (prestrategy group). For patients treated between February 2022 and January 2023 (poststrategy group), a long-term filter was recommended for those with these risk factors, and a short-term filter was recommended for those without these risk factors. RESULTS The study population included 303 patients (prestrategy group, n = 154; poststrategy group, n = 149). Long-term immobilization (odds ratio [OR] = 38.000; 95% confidence interval [CI]: 6.858-210.564), active cancer (OR = 17.643; 95% CI: 5.462-56.993), and venous thromboembolism detected in the intensive care unit (OR = 28.500; 95% CI: 7.419-109.477) were identified as independent risk factors for nonretrieval of short-term filters. The total retrieval rate was significantly higher in the poststrategy group (87.2%) than in the prestrategy group (72.7%; P = 0.002); the short-term filter retrieval rate was also significantly higher in the poststrategy group (84.5%) than in the prestrategy group (68.5%; P < 0.001). CONCLUSION The proposed strategy for filter choice based on risk factors for short-term filter nonretrieval can accurately identify patients who need long-term filter placement while also increasing the retrieval rates for both short-term filters retrieval rates and overall retrieval rates.
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Affiliation(s)
- Lihao Qin
- Department of Interventional and Vascular Surgery, Changzhou No. 2 People's Hospital, Xinglong road 29, Changzhou, 213003, China
| | - Kai Wang
- Department of Interventional and Vascular Surgery, Changzhou No. 2 People's Hospital, Xinglong road 29, Changzhou, 213003, China
| | - Feng Tian
- Department of Interventional and Vascular Surgery, Changzhou No. 2 People's Hospital, Xinglong road 29, Changzhou, 213003, China
| | - Tongqing Xue
- Department of Interventional Radiology, Huaian Hospital of Huai'an City (Huaian Cancer Hospital), Huai'an, 223200, China.
| | - Zhongzhi Jia
- Department of Interventional and Vascular Surgery, Changzhou No. 2 People's Hospital, Xinglong road 29, Changzhou, 213003, China.
| | - Shaoqin Li
- Department of Interventional and Vascular Surgery, Changzhou No. 2 People's Hospital, Xinglong road 29, Changzhou, 213003, China.
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Fontyn S, Bai Y, Bolger S, Greco K, Wang TF, Hamm C, Cervi A. Inferior vena cava filter use at a large community hospital: a retrospective cohort study. Sci Rep 2024; 14:10192. [PMID: 38702341 PMCID: PMC11068867 DOI: 10.1038/s41598-024-60868-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
Inferior vena cava (IVC) filters are considered when patients with venous thromboembolism (VTE) develop a contraindication to anticoagulation. Use of IVC filters is increasing, despite associated complications and lack of data on efficacy in reducing VTE-related mortality. We characterized the pattern of IVC filter use at a large community hospital between 2018 and 2022. Specifically, we assessed the indications for IVC filter insertion, filter removal rates, and filter-associated complications. Indications for IVC filters were compared to those outlined by current clinical practice guidelines. We reviewed 120 consecutive filter placement events. The most common indications included recent VTE and active bleeding (40.0%) or need for anticoagulation interruption for surgery (25.8%). Approximately one-third (30.0%) of IVC filters were inserted for indications either not supported or addressed by guidelines. Half (50.0%) of patients had successful removal of their IVC filter. At least 13 patients (10.8%) experienced a filter-related complication. In a large community-based practice, nearly one-third of IVC filters were inserted for indications not universally supported by current practice guidelines. Moreover, most IVC filters were not removed, raising the risk of filter-associated complications, and supporting the need for development of comprehensive guidelines addressing use of IVC filters, and post-insertion monitoring practices.
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Affiliation(s)
| | - Yuxin Bai
- Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Samantha Bolger
- Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Kaity Greco
- Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Tzu-Fei Wang
- Department of Medicine, University of Ottawa at The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Canada
| | - Caroline Hamm
- Schulich School of Medicine and Dentistry, London, ON, Canada
- Department of Medical Oncology, Windsor Regional Cancer Centre, 1995 Lens Avenue, Windsor, ON, N8W 1L9, Canada
| | - Andrea Cervi
- Schulich School of Medicine and Dentistry, London, ON, Canada.
- Department of Medical Oncology, Windsor Regional Cancer Centre, 1995 Lens Avenue, Windsor, ON, N8W 1L9, Canada.
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Kang RD, Schuchardt P, Charles J, Kumar P, Drews E, Kazi S, DePalma A, Fang A, Raymond A, Davis C, Massis K, Hoots G, Mhaskar R, Nezami N, Shaikh J. Predictors of endobronchial forceps utilization for inferior vena cava filter retrieval: when snare retrieval fails. CVIR Endovasc 2023; 6:55. [PMID: 37950835 PMCID: PMC10640549 DOI: 10.1186/s42155-023-00392-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/15/2023] [Indexed: 11/13/2023] Open
Abstract
BACKGROUND Endobronchial forceps are commonly used for complex IVC filter removal and after initial attempts at IVC filter retrieval with a snare have failed. Currently, there are no clear guidelines to help distinguish cases where primary removal should be attempted with standard snare technique or whether attempts at removal should directly be started with forceps. This study is aimed to identify clinical and imaging predictors of snare failure which necessitate conversion to endobronchial forceps. METHODS Retrospective analysis of 543 patients who underwent IVC filter retrievals were performed at three large quaternary care centers from Jan 2015 to Jan 2022. Patient demographics and IVC filter characteristics on cross-sectional images (degree of tilt, hook embedment, and strut penetration, etc.) were reviewed. Binary multivariate logistic regression was used to identify predictors of IVC filter retrieval where snare retrieval would fail. RESULTS Thirty seven percent of the patients (n = 203) necessitated utilization of endobronchial forceps. IVC filter hook embedment (OR:4.55; 95%CI: 1.74-11.87; p = 0.002) and strut penetration (OR: 56.46; 95% CI 20.2-157.7; p = 0.001) were predictors of snare failure. In contrast, total dwell time, BMI, and degree of filter tilt were not associated with snare failure. Intraprocedural conversion from snare to endobronchial forceps was significantly associated with increased contrast volume, radiation dose, and total procedure times (p < 0.05). CONCLUSION IVC filter hook embedment and strut penetration were predictors of snare retrieval failure. Intraprocedural conversion from snare to endobronchial forceps increased contrast volume, radiation dose, and total procedure time. When either hook embedment or strut penetration is present on pre-procedural cross-sectional images, IVC filter retrieval should be initiated using endobronchial forceps. LEVEL OF EVIDENCE Level 3, large multicenter retrospective cohort.
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Affiliation(s)
- Richard D Kang
- University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Philip Schuchardt
- Department of Radiology, University of South Florida Health, Tampa General Hospital, Tampa, FL, USA
| | - Jonathan Charles
- University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Premsai Kumar
- Department of Radiology, University of South Florida Health, Tampa General Hospital, Tampa, FL, USA
| | - Elena Drews
- Department of Radiology and Image Guided Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Stephanie Kazi
- Department of Radiology and Image Guided Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Andres DePalma
- Department of Radiology and Image Guided Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Adam Fang
- Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Aislynn Raymond
- Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Cliff Davis
- Department of Radiology, University of South Florida Health, Tampa General Hospital, Tampa, FL, USA
- Radiology Associates of Florida, Tampa, FL, USA
| | - Kamal Massis
- Department of Radiology, University of South Florida Health, Tampa General Hospital, Tampa, FL, USA
- Radiology Associates of Florida, Tampa, FL, USA
| | - Glenn Hoots
- Department of Radiology, University of South Florida Health, Tampa General Hospital, Tampa, FL, USA
- Radiology Associates of Florida, Tampa, FL, USA
| | - Rahul Mhaskar
- Department of Radiology, University of South Florida Health, Tampa General Hospital, Tampa, FL, USA
| | - Nariman Nezami
- Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Experimental Therapeutics Program, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | - Jamil Shaikh
- Department of Radiology, University of South Florida Health, Tampa General Hospital, Tampa, FL, USA.
- Radiology Associates of Florida, Tampa, FL, USA.
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Santos Rodríguez AE, Lopera J. Inferior vena cava filter misplacement with SVC perforation. J Interv Med 2023; 6:140-142. [PMID: 37846336 PMCID: PMC10577063 DOI: 10.1016/j.jimed.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/11/2023] [Accepted: 06/21/2023] [Indexed: 10/18/2023] Open
Affiliation(s)
| | - Jorge Lopera
- The University of Texas Health Science Center at San Antonio, USA
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Shahid MU, Nirgudkar N, Chandra V, Gonzales S, Kumar A. Influence of Exercise on Inferior Vena Cava Wall Interaction with Inferior Vena Cava Filters: Results of a Pilot In Vivo Porcine Study. THE ARAB JOURNAL OF INTERVENTIONAL RADIOLOGY 2022. [DOI: 10.1055/s-0042-1757782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract
Purpose The aim of this study was to assess the effect of mild exercise on inferior vena cava (IVC) filter interaction with imaging and pathological features with the neighboring vessel wall utilizing a porcine model.
Methods After Institutional Animal Care and Use Committee (IACUC) approval, retrievable Option Elite IVC filters were implanted in six Yorkshire pigs utilizing the right common femoral vein approach under general anesthesia. Group A (n = 4) pigs remained sedentary for 4 weeks. Group B (n = 2) pigs were exercised using a harness and treadmill for 10 minutes/day for 4 days/week. At approximately 4 weeks, IVC venograms were performed and the pigs were sacrificed. After laparotomy, the IVC was ligated above and below the filter, excised and fixed in formalin. Gross and histological examination of the IVC was performed. Gross images of each sample were captured before removal of the filters. One longitudinal, one tangential, and five transverse representative sections were processed for paraffin sectioning and hematoxylin and eosin slides were prepared. A pathologist examined all tissues to assess differences between normal vein, group A and group B pigs. The pathologist provided an overall assessment and representative images.
Results All IVC filter implantations were technically successful without adverse effects. There was no incidence of caval thrombosis, filter strut fracture, or filter migration in either group. On gross pathological examination, IVC of the pigs in group B demonstrated more perivascular and mural fibrosis than those pigs in group A. Histopathological findings correlated with gross findings.
Conclusions In this pilot study, there were no incidence of IVC filter strut fracture, penetration or IVC occlusion in sedentary or exercised pigs. However, there tended to be more perivascular and mural fibrosis on pathological examination of inferior vena cavas from exercised pigs. Further larger scale studies may employ the porcine model to further understand the role exercise may play on IVC filter and caval wall interaction.
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Affiliation(s)
- M. Usman Shahid
- Department of Radiology, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Neel Nirgudkar
- Department of Radiology, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Vishnu Chandra
- Department of Radiology, University of Virginia Medical School, Charlottesville, Virginia, United States
| | - Sharon Gonzales
- Department of Radiology, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Abhishek Kumar
- Department of Radiology, Rutgers New Jersey Medical School, Newark, New Jersey, United States
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Siah TH, Habib Z, McWilliams RG, Chan TY. Implications for patient follow-up of changes in inferior vena cava filter removal plan practices. Clin Radiol 2022; 77:794-799. [PMID: 35985844 DOI: 10.1016/j.crad.2022.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 06/23/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022]
Abstract
AIM To assess the improvements during patient follow-up after implementing a proactive plan for retrieval of inferior vena cava (IVC) filters. MATERIALS AND METHODS A retrospective study was undertaken including all patients who had a temporary IVC filter inserted over a 10-year period. Patient demographics, insertion dates, retrieval dates, retrieval rates, and complications were recorded. Patients were categorised into three groups as follows: group A, no intervention where retrieval was not suggested; group B, passive intervention where retrieval was suggested but no appointment made; and group C, proactive intervention where a retrieval date was booked by the radiologist. RESULTS Five hundred and nine patients had a temporary IVC filter inserted at Royal Liverpool University Hospital over the study period. One per cent of patients in group C were lost to follow-up compared to 41% and 29% in groups A and B respectively (p<0.001). The number of patients who had an IVC retrieval attempt also increased to 80% in group C compared to 53% and 64% in groups A and B (p<0.001). CONCLUSION Incorporation of a proactive retrieval booking system has significantly reduced the number of patients lost to follow-up to 1%, leading to an increased number of IVC filter retrieval attempts.
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Affiliation(s)
- T H Siah
- Department of Radiology, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Prescot Street, Liverpool L7 8XP, UK.
| | - Z Habib
- Department of Radiology, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Prescot Street, Liverpool L7 8XP, UK
| | - R G McWilliams
- Department of Radiology, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Prescot Street, Liverpool L7 8XP, UK
| | - T Y Chan
- Department of Radiology, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Prescot Street, Liverpool L7 8XP, UK
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Zhang L, Li M, Zhu Y, Shi Z, Zhang W, Gao B, Li L, Fang Z, Yang G, Han W, Wang L, Yin L, Ke X, Yue J, Gu Z, Liu Z. Efficacy and safety of rivaroxaban in patients with inferior vena cava filter placement without anticoagulation contraindications (EPICT): a prospective randomised controlled trial study protocol. BMJ Open 2021; 11:e045530. [PMID: 34697109 PMCID: PMC8547359 DOI: 10.1136/bmjopen-2020-045530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Inferior vena cava (IVC) filters are commonly used in patients with venous thromboembolism to prevent fatal pulmonary embolism, but the thrombosis risk increases after filter placement. Warfarin is a widely anticoagulant, but long-term monitoring and dose adjustments are required. Anticoagulation with rivaroxaban is more straightforward as it dose not require laboratory monitoring. This study compares the efficacy and safety of rivaroxaban and warfarin as an in anticoagulation therapy for patients with IVC filter placement. METHODS AND ANALYSIS This is a multicentre, randomised controlled trial. In total, 200 patients with deep vein thrombosis (DVT) with IVC filter implantation from 10 hospitals will be recruited. The patients will be randomised to the experimental group (rivaroxaban) or the control group (nadroparin overlapped with warfarin). The primary outcomes include death of any cause, pulmonary embolism (PE)-related death, bleeding and recurrent PE/DVT. The secondary outcomes include the percentage of other vascular events, IVC filter retrieval failure and net clinical benefits. This study aims to provide reliable, verification for the efficacy and safety of rivaroxaban antithrombotic therapy after IVC filter placement. ETHICS AND DISSEMINATION The study was approved by the Human Research Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (approval number: (2019) 295). The results will be disseminated through presentations at scientific conferences and publications in peer-reviewed journals TRIAL REGISTRATION NUMBER: NCT04066764.
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Affiliation(s)
- Libin Zhang
- Vascular Surgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, China
| | - Miaomiao Li
- Vascular Surgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, China
| | - Yuefeng Zhu
- Vascular Surgery, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Zhenyu Shi
- Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, China
| | - Wan Zhang
- Vascular Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Bin Gao
- Vascular Surgery, Shanghai Fifth People's Hospital, Shanghai, China
| | - Lubin Li
- Vascular Surgery, Qindao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Zhengdong Fang
- Vascular Surgery, Anhui Provincial Hospital, Hefei, Anhui, China
| | - Guangwei Yang
- Vascular Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China
| | - Wei Han
- Vascualr Surgery, Zhejiang Xiaoshan Hospital, Hangzhou, Zhejiang, China
| | - Linjun Wang
- Vascular Surgery, Third Peoplles Hospital of Hangzhou, Hangzhou, Zhejiang, China
| | - Li Yin
- Vascular Surgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, China
| | - Xueying Ke
- Vascular Surgery, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Jianing Yue
- Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, China
| | - Zheng Gu
- Department of Clinical Medicine Engineering, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Zhenjie Liu
- Vascular Surgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, China
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Cardiac Tamponade Secondary to IVC Filter Retrieval. JACC Case Rep 2020; 2:873-876. [PMID: 34317371 PMCID: PMC8302023 DOI: 10.1016/j.jaccas.2020.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/27/2020] [Accepted: 04/03/2020] [Indexed: 01/15/2023]
Abstract
Cardiac tamponade is a rare but potentially fatal complication of inferior vena cava filter retrieval. We discuss such a case to facilitate prompt recognition and prevention of this complication by medical providers. (Level of Difficulty: Beginner.)
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9
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A review of anticoagulation in patients with central nervous system malignancy: between a rock and a hard place. J Neurol 2020; 268:2390-2401. [PMID: 32124043 DOI: 10.1007/s00415-020-09775-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
The incidence and prevalence of patients who develop primary and secondary metastatic central nervous system cancer (CNS) is increasing. This is a consequence of advancements in the sensitivity and availability of diagnostic imaging, and improved therapeutic options, leading to increased detection of CNS malignancies and improved survival. These patients are at very high risk of thrombosis as well as haemorrhage, and the optimum management of anticoagulation can be challenging for treating clinicians, particularly as robust prospective evidence is sparse. In this focused review, we discuss (1) risk factors for thrombosis and bleeding in these patients, (2) management of acute venous thromboembolism (VTE) including evidence for direct oral anticoagulants, and how to approach patients with contraindications to anticoagulation, (3) ambulatory VTE prophylaxis, (4) VTE prophylaxis in patients who have undergone craniotomy for cancer, and (5) management of anticoagulation-related intracranial haemorrhage. Based on review of the available literature and author opinion, we propose practical management algorithms to aid clinicians faced with treating CNS cancer patients with thrombosis or CNS haemorrhage.
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Predicting the Safety and Effectiveness of Inferior Vena Cava Filters Study: Design of a unique safety and effectiveness study of inferior vena cava filters in clinical practice. J Vasc Surg Venous Lymphat Disord 2020; 8:187-194.e1. [DOI: 10.1016/j.jvsv.2019.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 07/18/2019] [Indexed: 11/18/2022]
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Mozgovoĭ PV, Ziubina EN, Spiridonov EG, Vorob'ev AA, Mandrikov VV, Zharkin FN, Lukovskova AA, Ufimtsev VS. [Total laparoscopic retrieval of a cava filter: case series]. ANGIOLOGIIA I SOSUDISTAIA KHIRURGIIA = ANGIOLOGY AND VASCULAR SURGERY 2020; 26:149-154. [PMID: 33332317 DOI: 10.33529/angio2020422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Despite the fact that prevention and treatment of venous thromboembolic complications are based on anticoagulant therapy in cases where there are contraindications, complications, as well as in case of inefficiency of the carried out anticoagulant therapy, installation of a cava filter is indicated. The necessity of subsequent retrieval of this device from the inferior vena cava is associated with a potential risk of the development of complications. Analysed herein is a case series concerning management of 4 patients undergoing treatment from February 2015 to March 2017. Attempts of endovascular retrieval of the cava filter turned out unsuccessful. The patients were therefore subjected to total laparoscopic retrieval of the cava filter. The time required for phlebotomy, retrieval of the filter, and suturing of the phlebectomy zone ranged from 32 to 45 min. The maximal blood loss amounted to 300 ml, not requiring transfusion of blood preparations. Neither was required conversion to laparotomy in any case. No significant systemic or wound complications in the postoperative period were observed. A conclusion drawn is that in case of failed attempts at endovascular retrieval, given that a surgical team has broad experience in performing laparoscopic and angiosurgical operations, total laparoscopic retrieval of a cava filter may be considered a relatively safe minimally invasive method of managing the patient cohort concerned.
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Affiliation(s)
- P V Mozgovoĭ
- Clinic #1, Volgograd State Medical University of the RF Ministry of Public Health, Volgograd, Russia
| | - E N Ziubina
- Clinic #1, Volgograd State Medical University of the RF Ministry of Public Health, Volgograd, Russia
| | - E G Spiridonov
- Clinic #1, Volgograd State Medical University of the RF Ministry of Public Health, Volgograd, Russia
| | - A A Vorob'ev
- Clinic #1, Volgograd State Medical University of the RF Ministry of Public Health, Volgograd, Russia
| | - V V Mandrikov
- Clinic #1, Volgograd State Medical University of the RF Ministry of Public Health, Volgograd, Russia
| | - F N Zharkin
- Clinic #1, Volgograd State Medical University of the RF Ministry of Public Health, Volgograd, Russia
| | - A A Lukovskova
- Clinic #1, Volgograd State Medical University of the RF Ministry of Public Health, Volgograd, Russia
| | - V S Ufimtsev
- Clinic #1, Volgograd State Medical University of the RF Ministry of Public Health, Volgograd, Russia
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