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CardioVascular and Interventional Radiology

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01-07-2008 | Clinical Investigation

Retrievable Vena Cava Filters in Major Trauma Patients: Prevalence of Thrombus Within the Filter

Authors: Arie Mahrer, Douglas Zippel, Alexander Garniek, Gil Golan, Paul Bensaid, Daniel Simon, Uri Rimon

Published in: CardioVascular and Interventional Radiology | Issue 4/2008

Abstract

The purpose of this study was to report the prevalence of thrombus within a retrievable vena cava filter inserted prophylactically in major trauma patients referred for filter extraction. Between November 2002 and August 2005, 80 retrievable inferior vena cava filters (68 Optease and 12 Gunther-Tulip) were inserted into critically injured trauma patients (mean injury severity score 33.5). The filters were inserted within 1 to 6 (mean 2) days of injury. Thirty-seven patients were referred for filter removal (32 with Optease and 5 with Gunther-Tulip). The indwelling time was 7 to 22 (mean 13) days. All patients underwent inferior vena cavography prior to filter removal. There were no insertion-related complications and all filters were successfully deployed. Forty-three (54%) of the 80 patients were not referred for filter removal, as these patients continued to have contraindications to anticoagulation. Thirty-seven patients (46%) were referred for filter removal. In eight of them (22%) a large thrombus was seen within the filters and they were left in place, all with the Optease device. The other 29 filters (36%) were removed uneventfully.

We conclude that the relatively high prevalence of intrafilter thrombi with the Optease filter may be explained by either spontaneous thrombus formation or captured emboli.

Geerts WH, Code KI, Jay RM et al (1994) A prospective study of venous thromboembolism after major trauma. N Engl J Med 331:1601–1606PubMedCrossRef

Kaufman JA, Kinney TB, Streiff MB et al (2006) Guidelines for the use of retrievable and convertible vena cava filters: report from the Society of Interventional Radiology multidisciplinary consensus conference. J Vasc Interv Radiol 17:449–459PubMedCrossRef

Laciewicz PF, Soileau ES (2006) Multimodal prophylaxis for THA with mechanical compression. Clin Orthop Relat Res 453:225–230CrossRef

Morris CS, Rogers FB, Najarian KE, Bhave AD, Shackford SR (2004) Current trends in vena caval filtration with the introduction of a retrievable filter at a level I trauma center. J Trauma 57:32–36PubMedCrossRef

The PREPIC Study Group (2005) Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism. The PREPIC (Prévention du risque d’embolie pulmonaire par interruption cave) randomized study. Circulation 112:416–422CrossRef

Joels CS, Sing RF, Heniford BT (2003) Complications of inferior vena cava filters. Am Surg 69:654–659PubMed

Baker SP, O’Neill B, Haddon W Jr, Long WB (1974) The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 14:187–196PubMedCrossRef

Rogers FB, Cipolle MD, Velmahos G, Rozycki G, Luchette FA (2002) Practice management guidelines for the prevention of venous thromboembolism in trauma patients: the EAST practice management guidelines work group. J Trauma 53:142–164PubMedCrossRef

Terhaar OA, Lyon SM, Given MF, Foster AE, Mc Grath F, Lee MJ (2004) Extended interval for retrieval of Gunther Tulip filters. J Vasc Interv Radiol 15:1257–1262PubMed

10.

Geerts WH, Jay RM, Code KI et al (1996) A comparison of low-dose heparin with low-molecular-weight heparin as prophylaxis against venous thromboembolism after major trauma. N Engl J Med 335:701–707PubMedCrossRef

11.

Rogers FB, Shackford SR, Wilson J et al (1993) Prophylactic vena cava filter insertion in severely injured trauma patients: indications and preliminary results. J Trauma 35:637–642PubMedCrossRef

12.

Grande WJ, Trerotola SO, Reilly PM et al (2005) Experience with the recovery filter as a retrievable inferior vena cava filter. J Vasc Interv Radiol 16:1189–1193PubMed

13.

Millward SF, Oliva VL, Bell SD et al (2001) Gunther tulip retrievable vena cava filter: results from the registry of the Canadian interventional radiology association. J Vasc Interv Radiol 2:1053–1058CrossRef

14.

Wicky S, Doenz F, Meuwly JY, Portier F, Schnyder P, Denys A (2003) Clinical experience with retrievable Gunther Tulip vena cava filters. J Endovasc Ther 10:994–1000PubMedCrossRef

15.

de Gregorio MA, Gamboa P, Gimeno MJ et al (2003) The Gunther Tulip retrievable filter: prolonged temporary filtration by repositioning within the inferior vena cava. J Vasc Interv Radiol 14:1259–1265PubMed

16.

Neuerburg JM, Gunther RW, Vorwerk D et al (1997) Results of a multicenter study of the retrievable Tulip vena cava filter: early clinical experience. CardioVasc Interv Radiol 20:10–16CrossRef

17.

Kinney TB (2003) Update of inferior vena cava filters. J Vasc Interv Radiol 14:425–440PubMed

18.

Oliva VL, Szatmari F, Giroux MF, Flemming BK, Cohen SA, Soulez G (2005) The Jonas study: evaluation of the retrievability of the Cordis OptEase inferior vena cava filter. J Vasc Interv Radiol 16:1423–1425CrossRef

19.

Rosenthal D, Wellons ED, Levitt AB, Shuler FW, O’Conner RE, Henderson VJ (2004) Role of prophylactic temporary inferior vena cava filters placed at the ICU bedside under intravascular ultrasound guidance in patients with multiple trauma. J Vasc Surg 40:958–964PubMedCrossRef

20.

Keller IS, Meier C, Pfiffner R, Keller E, Pfammatter T (2007) Clinical comparison of two optional vena cava filters. J Vasc Interv Radiol 18:505–511PubMedCrossRef

21.

Karmy-Jones R, Jurkovich GJ, Velmahos GC et al (2007) Practice Patterns and outcomes of retrievable vena cava filters in trauma patients: an AAST multicenter study. J Trauma 62:17–25PubMedCrossRef

22.

Wang SL, Timmermans HA, Kaufman JA (2007) Estimation of trapped thrombus volumes in retrievable inferior vena cava filters: a visual scale. J Vasc Interv Radiol 18:273–276PubMedCrossRef

23.

Leask RL, Johnston KW, Ojha M (2004) Hemodynamic effects of clot entrapment in the TrapEase inferior vena cava filter. J Vasc Interv Radiol 15:485–490PubMed

Title: Retrievable Vena Cava Filters in Major Trauma Patients: Prevalence of Thrombus Within the Filter
Authors: Arie Mahrer
Douglas Zippel
Alexander Garniek
Gil Golan
Paul Bensaid
Daniel Simon
Uri Rimon
Publication date: 01-07-2008
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 4/2008
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-008-9294-8

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Retrievable Vena Cava Filters in Major Trauma Patients: Prevalence of Thrombus Within the Filter

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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