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Outcomes of retrievable inferior vena cava filters in patients with deep vein thrombosis and transient contraindication for anticoagulation.

Kim HK, Song I, Jang JH, Oh CW, Lee JM, Huh S - Ann Surg Treat Res (2015)

Bottom Line: The indications for IVCF were recent trauma including surgery in 48 patients, recent hemorrhage in 14, and planned major surgery with DVT in 8 patients.Follow-up CT of 61 patients (87%) was performed.Aggravation or new development of pulmonary embolism (PE) was not found in any patient.

View Article: PubMed Central - PubMed

Affiliation: Division of Vascular Surgery, Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT

Purpose: To determine the efficacy of a retrievable inferior vena cava filter (IVCF) for patients with deep vein thrombosis (DVT) and transient contraindication for anticoagulant therapy, and to analyze the risk factors for filter thrombus in these patients.

Methods: We retrospectively reviewed the records of 70 patients who received a retrievable IVCF from January 2007 to June 2014 because of documented DVT and transient contraindication for anticoagulant therapy. The protocol for follow-up care generally consisted of anticoagulant therapy after high-risk periods, follow-up CT around 2 weeks after IVCF placement, and retrieval if possible.

Results: The 70 patients had a mean age of 61.8 years (range, 17-88 years), and 30 were male (43%). The indications for IVCF were recent trauma including surgery in 48 patients, recent hemorrhage in 14, and planned major surgery with DVT in 8 patients. Follow-up CT of 61 patients (87%) was performed. Aggravation or new development of pulmonary embolism (PE) was not found in any patient. Filter thrombus was detected in 23% of patients with follow-up CT (14/61). Filter thrombus was not detected in patients with isolated calf vein thrombosis (ICVT) (P = 0.079). The risk factor for filter thrombus was DVT progression on follow-up CT (P = 0.007) on multivariate analysis.

Conclusion: For patients with DVT and transient contraindication for anticoagulant therapy, a retrievable IVCF could prevent the aggravation or new development of PE. DVT progression on follow-up CT was associated with filter thrombus and ICVT was not related to filter thrombus in the present study.

No MeSH data available.


Related in: MedlinePlus

Examples of filter thrombus on follow-up CT. (A) Image from a 57-year-old man with a pelvic bone fracture and femoropopliteal deep vein thrombosis who had a Celect filter inserted preoperatively. After 14 days, follow-up CT scan showed filter thrombus within inferior vena cava filter (arrow). (B) Image from a 51-year-old woman with cerebral hemorrhage and popliteal vein thrombosis who received a Celect filter inserted for prevention of further pulmonary embolism. After 11 days, follow-up CT scan showed filter thrombus with total thrombotic occlusion of inferior vena cava filter distal to the filter (arrow).
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Figure 1: Examples of filter thrombus on follow-up CT. (A) Image from a 57-year-old man with a pelvic bone fracture and femoropopliteal deep vein thrombosis who had a Celect filter inserted preoperatively. After 14 days, follow-up CT scan showed filter thrombus within inferior vena cava filter (arrow). (B) Image from a 51-year-old woman with cerebral hemorrhage and popliteal vein thrombosis who received a Celect filter inserted for prevention of further pulmonary embolism. After 11 days, follow-up CT scan showed filter thrombus with total thrombotic occlusion of inferior vena cava filter distal to the filter (arrow).

Mentions: Of the 61 patients who underwent a follow-up CT scan, filter thrombosis was detected in 14 (23%). Of these 14 patients, 11 had an isolated trapped embolus in the IVCF, and 3 had total IVC occlusion distal to the IVCF (Fig. 1). In univariate risk factor analysis for filter thrombosis, DVT progression on follow-up CT was demonstrated as a significant risk factor for filter thrombosis (P = 0.007). ICVT tended to be a negative predictor of filter thrombosis (P = 0.079). There was no filter thrombosis in patients with ICVT at initial presentation (Table 2). Multivariate analysis for filter thrombosis using logistic regression revealed that DVT progression on follow-up CT was the only significant independent risk factor for filter thrombosis (P = 0.007; OR, 8.750; 95% CI, 1.794-42.673).


Outcomes of retrievable inferior vena cava filters in patients with deep vein thrombosis and transient contraindication for anticoagulation.

Kim HK, Song I, Jang JH, Oh CW, Lee JM, Huh S - Ann Surg Treat Res (2015)

Examples of filter thrombus on follow-up CT. (A) Image from a 57-year-old man with a pelvic bone fracture and femoropopliteal deep vein thrombosis who had a Celect filter inserted preoperatively. After 14 days, follow-up CT scan showed filter thrombus within inferior vena cava filter (arrow). (B) Image from a 51-year-old woman with cerebral hemorrhage and popliteal vein thrombosis who received a Celect filter inserted for prevention of further pulmonary embolism. After 11 days, follow-up CT scan showed filter thrombus with total thrombotic occlusion of inferior vena cava filter distal to the filter (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4481029&req=5

Figure 1: Examples of filter thrombus on follow-up CT. (A) Image from a 57-year-old man with a pelvic bone fracture and femoropopliteal deep vein thrombosis who had a Celect filter inserted preoperatively. After 14 days, follow-up CT scan showed filter thrombus within inferior vena cava filter (arrow). (B) Image from a 51-year-old woman with cerebral hemorrhage and popliteal vein thrombosis who received a Celect filter inserted for prevention of further pulmonary embolism. After 11 days, follow-up CT scan showed filter thrombus with total thrombotic occlusion of inferior vena cava filter distal to the filter (arrow).
Mentions: Of the 61 patients who underwent a follow-up CT scan, filter thrombosis was detected in 14 (23%). Of these 14 patients, 11 had an isolated trapped embolus in the IVCF, and 3 had total IVC occlusion distal to the IVCF (Fig. 1). In univariate risk factor analysis for filter thrombosis, DVT progression on follow-up CT was demonstrated as a significant risk factor for filter thrombosis (P = 0.007). ICVT tended to be a negative predictor of filter thrombosis (P = 0.079). There was no filter thrombosis in patients with ICVT at initial presentation (Table 2). Multivariate analysis for filter thrombosis using logistic regression revealed that DVT progression on follow-up CT was the only significant independent risk factor for filter thrombosis (P = 0.007; OR, 8.750; 95% CI, 1.794-42.673).

Bottom Line: The indications for IVCF were recent trauma including surgery in 48 patients, recent hemorrhage in 14, and planned major surgery with DVT in 8 patients.Follow-up CT of 61 patients (87%) was performed.Aggravation or new development of pulmonary embolism (PE) was not found in any patient.

View Article: PubMed Central - PubMed

Affiliation: Division of Vascular Surgery, Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT

Purpose: To determine the efficacy of a retrievable inferior vena cava filter (IVCF) for patients with deep vein thrombosis (DVT) and transient contraindication for anticoagulant therapy, and to analyze the risk factors for filter thrombus in these patients.

Methods: We retrospectively reviewed the records of 70 patients who received a retrievable IVCF from January 2007 to June 2014 because of documented DVT and transient contraindication for anticoagulant therapy. The protocol for follow-up care generally consisted of anticoagulant therapy after high-risk periods, follow-up CT around 2 weeks after IVCF placement, and retrieval if possible.

Results: The 70 patients had a mean age of 61.8 years (range, 17-88 years), and 30 were male (43%). The indications for IVCF were recent trauma including surgery in 48 patients, recent hemorrhage in 14, and planned major surgery with DVT in 8 patients. Follow-up CT of 61 patients (87%) was performed. Aggravation or new development of pulmonary embolism (PE) was not found in any patient. Filter thrombus was detected in 23% of patients with follow-up CT (14/61). Filter thrombus was not detected in patients with isolated calf vein thrombosis (ICVT) (P = 0.079). The risk factor for filter thrombus was DVT progression on follow-up CT (P = 0.007) on multivariate analysis.

Conclusion: For patients with DVT and transient contraindication for anticoagulant therapy, a retrievable IVCF could prevent the aggravation or new development of PE. DVT progression on follow-up CT was associated with filter thrombus and ICVT was not related to filter thrombus in the present study.

No MeSH data available.


Related in: MedlinePlus