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López N, Zamora-Martinez C, Montoya-Rodes M, Gabara C, Ortiz M, Aibar J. Comparison of inferior vena cava filter use and outcomes between cancer and non-cancer patients in a tertiary hospital. Thromb Res 2024; 236:136-143. [PMID: 38447420 DOI: 10.1016/j.thromres.2024.02.020] [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: 09/07/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND While accepted indications for the use of inferior vena cava filter (IVCF) in patients with a venous thromboembolism (VTE) have remained stable, their use continues to be frequent. Retrieval rates are still low, being particularly notable in the population with cancer. This study aims to review the rate of adherence to guidelines recommendation and to compare retrieval rates and complications in both cancer and non-cancer patients. METHODS A retrospective study was performed including 185 patients in whom an IVCF was placed in Hospital Clinic of Barcelona. Baseline characteristics, clinical outcomes, and IVCF-related outcomes were analyzed. A strongly recommended indication (SRI) was considered if it was included in all the revised clinical guidelines and non-strongly if it was included in only some. RESULTS Overall, 47 % of the patients had a SRI, without differences between groups. IVCF placement after 29 days from the VTE event was more frequent in the cancer group (46.1 vs. 17.7 %). Patients with cancer (48.1 % of the cohort) were older, with higher co-morbidity and bleeding risk. Anticoagulation resumption (75.3 % vs. 92.7 %) and IVCF retrieval (50.6 % vs. 66.7 %) were significantly less frequent in cancer patients. No significant differences were found regarding IVCF-related complications, hemorrhagic events and VTE recurrence. CONCLUSIONS SRI of IVCF placement was found in less than half of the patients. Cancer patients had higher rates of IVCF placement without indication and lower anticoagulation resumption and IVCF retrieval ratios, despite complications were similar in both groups.
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Affiliation(s)
- Néstor López
- Internal Medicine Department, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Carles Zamora-Martinez
- Medical Oncology Department, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain.
| | - Marc Montoya-Rodes
- Internal Medicine Department, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Cristina Gabara
- Internal Medicine Department, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - María Ortiz
- Internal Medicine Department, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Jesús Aibar
- Internal Medicine Department, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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Damasco JA, Huang SY, Perez JVD, Manongdo JAT, Dixon KA, Williams ML, Jacobsen MC, Barbosa R, Canlas GM, Chintalapani G, Melancon AD, Layman RR, Fowlkes NW, Whitley EM, Melancon MP. Bismuth Nanoparticle and Polyhydroxybutyrate Coatings Enhance the Radiopacity of Absorbable Inferior Vena Cava Filters for Fluoroscopy-Guided Placement and Longitudinal Computed Tomography Monitoring in Pigs. ACS Biomater Sci Eng 2022; 8:1676-1685. [PMID: 35343679 PMCID: PMC9045416 DOI: 10.1021/acsbiomaterials.1c01449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Inferior vena cava filters (IVCFs) constructed with poly-p-dioxanone (PPDO) are promising alternatives to metallic filters and their associated risks and complications. Incorporating high-Z nanoparticles (NPs) improves PPDO IVCFs' radiopacity without adversely affecting their safety or performance. However, increased radiopacity from these studies are insufficient for filter visualization during fluoroscopy-guided PPDO IVCF deployment. This study focuses on the use of bismuth nanoparticles (BiNPs) as radiopacifiers to render sufficient signal intensity for the fluoroscopy-guided deployment and long-term CT monitoring of PPDO IVCFs. The use of polyhydroxybutyate (PHB) as an additional layer to increase the surface adsorption of NPs resulted in a 2-fold increase in BiNP coating (BiNP-PPDO IVCFs, 3.8%; BiNP-PPDO + PHB IVCFs, 6.2%), enabling complete filter visualization during fluoroscopy-guided IVCF deployment and, 1 week later, clot deployment. The biocompatibility, clot-trapping efficacy, and mechanical strength of the control PPDO (load-at-break, 6.23 ± 0.13 kg), BiNP-PPDO (6.10 ± 0.09 kg), and BiNP-PPDO + PHB (6.15 ± 0.13 kg) IVCFs did not differ significantly over a 12-week monitoring period in pigs. These results indicate that BiNP-PPDO + PHB can increase the radiodensity of a novel absorbable IVCF without compromising device strength. Visualizing the device under conventional radiographic imaging is key to allow safe and effective clinical translation of the device.
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Affiliation(s)
- Jossana A Damasco
- Departments of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
| | - Steven Y Huang
- Departments of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
| | - Joy Vanessa D Perez
- Departments of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
| | | | - Katherine A Dixon
- Departments of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
| | - Malea L Williams
- Departments of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
| | - Megan C Jacobsen
- Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
| | - Roland Barbosa
- Covalent Metrology Sunnyvale, Sunnyvale, California 94085, United States
| | - Gino Martin Canlas
- Department of Chemistry, Lamar University, Beaumont, Texas 77710, United States
| | | | - Adam D Melancon
- Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
| | - Rick R Layman
- Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
| | - Natalie W Fowlkes
- Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
| | - Elizabeth M Whitley
- Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
| | - Marites P Melancon
- Departments of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
- UT Health Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States
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Craven P, Daly C, Sikotra N, Clay T, Gabbay E. Dilemmas in anticoagulation and use of inferior vena cava filters in venous thromboembolism; a survey of Respiratory Physicians, Haematologists and Medical Oncologists and a review of the literature. Pulm Circ 2021; 11:2045894020953841. [PMID: 33456754 PMCID: PMC7797600 DOI: 10.1177/2045894020953841] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 08/07/2020] [Indexed: 01/01/2023] Open
Abstract
Twenty percent of patients with Cancer Associated Thrombosis receive an inferior vena
cava filter annually. Insertion is guided by practice guidelines, which do not specify or
discuss the use of inferior vena cava filters in malignancy. Adherence to these guidelines
is known to be variable. We aimed to see if there was consistent management of venous
thromboembolism among Medical Oncologists/Haematologists and Respiratory Physicians, with
respect to inferior vena cava filter use in the setting of suspected and confirmed
malignancy. Medical Oncologists, Haematologists and Respiratory Physicians were surveyed
with four theoretical cases. Case 1 concerns a patient who develops a pulmonary embolism
following spinal surgery. Cases 2 and 4 explore the use of inferior vena cava filters in
the setting of malignancy. Case 3 covers the role of inferior vena cava filters in
recurrent thrombosis despite systemic anticoagulation. There were 56 responses, 32 (57%)
Respiratory Physicians and 24 (43%) Haematologists/Oncologists. Respiratory Physicians
were significantly more likely to insert an inferior vena cava filter in case 1
(p = 0.04) whilst Haematologists/Medical Oncologists were more likely
to insert an inferior vena cava filter in case 3 (p = 0.03). No
significant differences were found in cases 2 and 4. There were significant disparities in
terms of type and timing of anticoagulation. Consistency of recommendations with
guidelines was variable likely in part because guidelines are themselves inconsistent. The
heterogeneity in responses highlights the variations in venous thromboembolism management,
especially in Cancer Associated Thrombosis. International Societies should consider
addressing inferior vena cava filter use specifically in the setting of Cancer Associated
Thrombosis. Collaboration between interested specialities would assist in developing
consistent, evidence-based guidelines for the use of inferior vena cava filters in the
management of venous thromboembolism.
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Affiliation(s)
- Philip Craven
- Department of Respiratory Medicine, St John of God Healthcare, Subiaco, Australia.,Bendat Respiratory Research and Development Fund, St John of God Healthcare, Subiaco, Australia
| | - Ciara Daly
- Bendat Respiratory Research and Development Fund, St John of God Healthcare, Subiaco, Australia.,Department of Medical Oncology, St John of God Healthcare, Subiaco, Australia
| | - Nisha Sikotra
- Bendat Respiratory Research and Development Fund, St John of God Healthcare, Subiaco, Australia.,Research Department, St John of God Healthcare, Subiaco, Australia
| | - Tim Clay
- Bendat Respiratory Research and Development Fund, St John of God Healthcare, Subiaco, Australia.,Department of Medical Oncology, St John of God Healthcare, Subiaco, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Eli Gabbay
- Department of Respiratory Medicine, St John of God Healthcare, Subiaco, Australia.,Bendat Respiratory Research and Development Fund, St John of God Healthcare, Subiaco, Australia.,Research Department, St John of God Healthcare, Subiaco, Australia.,Department of Medical Teaching, St John of God Healthcare, Subiaco, Australia
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Update on extended prophylaxis for venous thromboembolism following surgery for gynaecological cancers. THROMBOSIS UPDATE 2021. [DOI: 10.1016/j.tru.2021.100038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Murata M, Inui K, Ikeda Y, Hasegawa G, Nakagawa Y, Nishiyama T, Tomita Y. Retroperitoneal extragonadal seminoma developed with acute lower inferior vena cava syndrome: A case report. Urol Case Rep 2018; 20:72-74. [PMID: 30069432 PMCID: PMC6067061 DOI: 10.1016/j.eucr.2018.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 07/04/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
- Masaki Murata
- Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kohei Inui
- Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yohei Ikeda
- Department of Diagnostic Radiology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Go Hasegawa
- Department of Pathology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yuki Nakagawa
- Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Tsutomu Nishiyama
- Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yoshihiko Tomita
- Division of Urology, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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