Practice Patterns and Outcomes of Retrievable Vena Cava Filters in Trauma Patients: An AAST Multicenter Study
BACKGROUND:The purpose of this study is to describe practice patterns and outcomes of posttraumatic retrievable inferior vena caval filters (R-IVCF). METHODS:A retrospective review of R-IVCFs placed during 2004 at 21 participating centers with follow up to July 1, 2005 was performed. Primary outcome...
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| Veröffentlicht in: | The journal of trauma 2007-01, Vol.62 (1), p.17-25 |
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| creator | Karmy-Jones, Riyad Jurkovich, Gregory J. Velmahos, George C. Burdick, Thomas Spaniolas, Konstantinos Todd, Samuel R. McNally, Michael Jacoby, Robert C. Link, Daniel Janczyk, Randy J. Ivascu, Felicia A. McCann, Michael Obeid, Farouck Hoff, William S. McQuay, Nathaniel Tieu, Brandon H. Schreiber, Martin A. Nirula, Ram Brasel, Karen Dunn, Julie A. Gambrell, Debbie Huckfeldt, Roger Harper, Jayna Schaffer, Kathryn B. Tominaga, Gail T. Vinces, Fausto Y. Sperling, David Hoyt, David Coimbra, Raul Rosengart, Mathew R. Forsythe, Raquel Cothren, Clay Moore, Ernest E. Haut, Elliott R. Hayanga, Awori J. Hird, Linda White, Christopher Grossman, Jodi Nagy, Kimberly Livaudais, West Wood, Rhonda Zengerink, Imme Kortbeek, John B. |
| description | BACKGROUND:The purpose of this study is to describe practice patterns and outcomes of posttraumatic retrievable inferior vena caval filters (R-IVCF).
METHODS:A retrospective review of R-IVCFs placed during 2004 at 21 participating centers with follow up to July 1, 2005 was performed. Primary outcomes included major complications (migration, pulmonary embolism [PE], and symptomatic caval occlusion) and reasons for failure to retrieve.
RESULTS:Of 446 patients (69% male, 92% blunt trauma) receiving R-IVCFs, 76% for prophylactic indications and 79% were placed by interventional radiology. Excluding 33 deaths, 152 were Gunter-Tulip (G-T), 224 Recovery (R), and 37 Optease (Opt). Placement occurred 6 ± 8 days after admission and retrieval at 50 ± 61 days. Follow up after discharge (5.7 ± 4.3 months) was reported in 51%. Only 22% of R-IVCFs were retrieved. Of 115 patients in whom retrieval was attempted, retrieval failed as a result of technical issues in 15 patients (10% of G-T, 14% of R, 27% of Opt) and because of significant residual thrombus within the filter in 10 patients (6% of G-T, 4% of R, 46% Opt). The primary reason R-IVCFs were not removed was because of loss to follow up (31%), which was sixfold higher (6% to 44%, p = 0.001) when the service placing the R-IVCF was not directly responsible for follow up. Complications did not correlate with mechanism, injury severity, service placing the R-IVCF, trauma volume, use of anticoagulation, age, or sex. Three cases of migration were recorded (all among R, 1.3%), two breakthrough PE (G-T 0.6% and R 0.4%) and six symptomatic caval occlusions (G-T 0, R 1%, Opt 11%) (p < 0.05 Opt versus both G-T and R).
CONCLUSION:Most R-IVCFs are not retrieved. The service placing the R-IVCF should be responsible for follow up. The Optease was associated with the greatest incidence of residual thrombus and symptomatic caval occlusion. The practice patterns of R-IVCF placement and retrieval should be re-examined. |
| doi_str_mv | 10.1097/TA.0b013e31802dd72a |
| format | Article |
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METHODS:A retrospective review of R-IVCFs placed during 2004 at 21 participating centers with follow up to July 1, 2005 was performed. Primary outcomes included major complications (migration, pulmonary embolism [PE], and symptomatic caval occlusion) and reasons for failure to retrieve.
RESULTS:Of 446 patients (69% male, 92% blunt trauma) receiving R-IVCFs, 76% for prophylactic indications and 79% were placed by interventional radiology. Excluding 33 deaths, 152 were Gunter-Tulip (G-T), 224 Recovery (R), and 37 Optease (Opt). Placement occurred 6 ± 8 days after admission and retrieval at 50 ± 61 days. Follow up after discharge (5.7 ± 4.3 months) was reported in 51%. Only 22% of R-IVCFs were retrieved. Of 115 patients in whom retrieval was attempted, retrieval failed as a result of technical issues in 15 patients (10% of G-T, 14% of R, 27% of Opt) and because of significant residual thrombus within the filter in 10 patients (6% of G-T, 4% of R, 46% Opt). The primary reason R-IVCFs were not removed was because of loss to follow up (31%), which was sixfold higher (6% to 44%, p = 0.001) when the service placing the R-IVCF was not directly responsible for follow up. Complications did not correlate with mechanism, injury severity, service placing the R-IVCF, trauma volume, use of anticoagulation, age, or sex. Three cases of migration were recorded (all among R, 1.3%), two breakthrough PE (G-T 0.6% and R 0.4%) and six symptomatic caval occlusions (G-T 0, R 1%, Opt 11%) (p < 0.05 Opt versus both G-T and R).
CONCLUSION:Most R-IVCFs are not retrieved. The service placing the R-IVCF should be responsible for follow up. The Optease was associated with the greatest incidence of residual thrombus and symptomatic caval occlusion. The practice patterns of R-IVCF placement and retrieval should be re-examined.</description><identifier>ISSN: 0022-5282</identifier><identifier>EISSN: 1529-8809</identifier><identifier>DOI: 10.1097/TA.0b013e31802dd72a</identifier><identifier>PMID: 17215729</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins, Inc</publisher><subject>Adult ; Device Removal ; Female ; Humans ; Male ; Postoperative Complications - epidemiology ; Practice Patterns, Physicians' - statistics & numerical data ; Pulmonary Embolism - etiology ; Pulmonary Embolism - prevention & control ; Retrospective Studies ; Treatment Outcome ; United States - epidemiology ; Vena Cava Filters - adverse effects ; Vena Cava Filters - utilization ; Wounds and Injuries - complications ; Wounds and Injuries - surgery</subject><ispartof>The journal of trauma, 2007-01, Vol.62 (1), p.17-25</ispartof><rights>2007 Lippincott Williams & Wilkins, Inc.</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4142-f18dd96c5003c8a5a509411d82c89c7871ba5a040f5faf2a93e2aabb28f444513</citedby><cites>FETCH-LOGICAL-c4142-f18dd96c5003c8a5a509411d82c89c7871ba5a040f5faf2a93e2aabb28f444513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27902,27903</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17215729$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karmy-Jones, Riyad</creatorcontrib><creatorcontrib>Jurkovich, Gregory J.</creatorcontrib><creatorcontrib>Velmahos, George C.</creatorcontrib><creatorcontrib>Burdick, Thomas</creatorcontrib><creatorcontrib>Spaniolas, Konstantinos</creatorcontrib><creatorcontrib>Todd, Samuel R.</creatorcontrib><creatorcontrib>McNally, Michael</creatorcontrib><creatorcontrib>Jacoby, Robert C.</creatorcontrib><creatorcontrib>Link, Daniel</creatorcontrib><creatorcontrib>Janczyk, Randy J.</creatorcontrib><creatorcontrib>Ivascu, Felicia A.</creatorcontrib><creatorcontrib>McCann, Michael</creatorcontrib><creatorcontrib>Obeid, Farouck</creatorcontrib><creatorcontrib>Hoff, William S.</creatorcontrib><creatorcontrib>McQuay, Nathaniel</creatorcontrib><creatorcontrib>Tieu, Brandon H.</creatorcontrib><creatorcontrib>Schreiber, Martin A.</creatorcontrib><creatorcontrib>Nirula, Ram</creatorcontrib><creatorcontrib>Brasel, Karen</creatorcontrib><creatorcontrib>Dunn, Julie A.</creatorcontrib><creatorcontrib>Gambrell, Debbie</creatorcontrib><creatorcontrib>Huckfeldt, Roger</creatorcontrib><creatorcontrib>Harper, Jayna</creatorcontrib><creatorcontrib>Schaffer, Kathryn B.</creatorcontrib><creatorcontrib>Tominaga, Gail T.</creatorcontrib><creatorcontrib>Vinces, Fausto Y.</creatorcontrib><creatorcontrib>Sperling, David</creatorcontrib><creatorcontrib>Hoyt, David</creatorcontrib><creatorcontrib>Coimbra, Raul</creatorcontrib><creatorcontrib>Rosengart, Mathew R.</creatorcontrib><creatorcontrib>Forsythe, Raquel</creatorcontrib><creatorcontrib>Cothren, Clay</creatorcontrib><creatorcontrib>Moore, Ernest E.</creatorcontrib><creatorcontrib>Haut, Elliott R.</creatorcontrib><creatorcontrib>Hayanga, Awori J.</creatorcontrib><creatorcontrib>Hird, Linda</creatorcontrib><creatorcontrib>White, Christopher</creatorcontrib><creatorcontrib>Grossman, Jodi</creatorcontrib><creatorcontrib>Nagy, Kimberly</creatorcontrib><creatorcontrib>Livaudais, West</creatorcontrib><creatorcontrib>Wood, Rhonda</creatorcontrib><creatorcontrib>Zengerink, Imme</creatorcontrib><creatorcontrib>Kortbeek, John B.</creatorcontrib><title>Practice Patterns and Outcomes of Retrievable Vena Cava Filters in Trauma Patients: An AAST Multicenter Study</title><title>The journal of trauma</title><addtitle>J Trauma</addtitle><description>BACKGROUND:The purpose of this study is to describe practice patterns and outcomes of posttraumatic retrievable inferior vena caval filters (R-IVCF).
METHODS:A retrospective review of R-IVCFs placed during 2004 at 21 participating centers with follow up to July 1, 2005 was performed. Primary outcomes included major complications (migration, pulmonary embolism [PE], and symptomatic caval occlusion) and reasons for failure to retrieve.
RESULTS:Of 446 patients (69% male, 92% blunt trauma) receiving R-IVCFs, 76% for prophylactic indications and 79% were placed by interventional radiology. Excluding 33 deaths, 152 were Gunter-Tulip (G-T), 224 Recovery (R), and 37 Optease (Opt). Placement occurred 6 ± 8 days after admission and retrieval at 50 ± 61 days. Follow up after discharge (5.7 ± 4.3 months) was reported in 51%. Only 22% of R-IVCFs were retrieved. Of 115 patients in whom retrieval was attempted, retrieval failed as a result of technical issues in 15 patients (10% of G-T, 14% of R, 27% of Opt) and because of significant residual thrombus within the filter in 10 patients (6% of G-T, 4% of R, 46% Opt). The primary reason R-IVCFs were not removed was because of loss to follow up (31%), which was sixfold higher (6% to 44%, p = 0.001) when the service placing the R-IVCF was not directly responsible for follow up. Complications did not correlate with mechanism, injury severity, service placing the R-IVCF, trauma volume, use of anticoagulation, age, or sex. Three cases of migration were recorded (all among R, 1.3%), two breakthrough PE (G-T 0.6% and R 0.4%) and six symptomatic caval occlusions (G-T 0, R 1%, Opt 11%) (p < 0.05 Opt versus both G-T and R).
CONCLUSION:Most R-IVCFs are not retrieved. The service placing the R-IVCF should be responsible for follow up. The Optease was associated with the greatest incidence of residual thrombus and symptomatic caval occlusion. The practice patterns of R-IVCF placement and retrieval should be re-examined.</description><subject>Adult</subject><subject>Device Removal</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Postoperative Complications - epidemiology</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Pulmonary Embolism - etiology</subject><subject>Pulmonary Embolism - prevention & control</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><subject>Vena Cava Filters - adverse effects</subject><subject>Vena Cava Filters - utilization</subject><subject>Wounds and Injuries - complications</subject><subject>Wounds and Injuries - surgery</subject><issn>0022-5282</issn><issn>1529-8809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV1r1UAQhhdR7LH6CwTZK-9SZ7-aXe_CoVWh0mKjt8tkM6HRfNTdTUv_vYnngODVMMPzPhfvMPZWwJkAV36oqzNoQChSwoJs21LiM7YTRrrCWnDP2Q5AysJIK0_Yq5R-AoDWyr5kJ6KUwpTS7dh4EzHkPhC_wZwpTonj1PLrJYd5pMTnjn-jHHt6wGYg_oMm5Ht8QH7ZDyueeD_xOuIy4iboacrpI68mXlW3Nf-6DJt6WkF-m5f26TV70eGQ6M1xnrLvlxf1_nNxdf3py766KoIWWhadsG3rzoMBUMGiQQNOC9FaGawLpS1Fsx5BQ2c67CQ6RRKxaaTttNZGqFP2_uC9j_PvhVL2Y58CDQNONC_Jn1strHQbqA5giHNKkTp_H_sR45MX4LeWfV35_1teU--O-qUZqf2XOda6AvoAPM5_W_o1LI8U_R3hkO_8-gcwqlSFBChBrFuxnaT6A_QIiKI</recordid><startdate>200701</startdate><enddate>200701</enddate><creator>Karmy-Jones, Riyad</creator><creator>Jurkovich, Gregory J.</creator><creator>Velmahos, George C.</creator><creator>Burdick, Thomas</creator><creator>Spaniolas, Konstantinos</creator><creator>Todd, Samuel R.</creator><creator>McNally, Michael</creator><creator>Jacoby, Robert C.</creator><creator>Link, Daniel</creator><creator>Janczyk, Randy J.</creator><creator>Ivascu, Felicia A.</creator><creator>McCann, Michael</creator><creator>Obeid, Farouck</creator><creator>Hoff, William S.</creator><creator>McQuay, Nathaniel</creator><creator>Tieu, Brandon H.</creator><creator>Schreiber, Martin A.</creator><creator>Nirula, Ram</creator><creator>Brasel, Karen</creator><creator>Dunn, Julie A.</creator><creator>Gambrell, Debbie</creator><creator>Huckfeldt, Roger</creator><creator>Harper, Jayna</creator><creator>Schaffer, Kathryn B.</creator><creator>Tominaga, Gail T.</creator><creator>Vinces, Fausto Y.</creator><creator>Sperling, David</creator><creator>Hoyt, David</creator><creator>Coimbra, Raul</creator><creator>Rosengart, Mathew R.</creator><creator>Forsythe, Raquel</creator><creator>Cothren, Clay</creator><creator>Moore, Ernest E.</creator><creator>Haut, Elliott R.</creator><creator>Hayanga, Awori J.</creator><creator>Hird, Linda</creator><creator>White, Christopher</creator><creator>Grossman, Jodi</creator><creator>Nagy, Kimberly</creator><creator>Livaudais, West</creator><creator>Wood, Rhonda</creator><creator>Zengerink, Imme</creator><creator>Kortbeek, John B.</creator><general>Lippincott Williams & Wilkins, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200701</creationdate><title>Practice Patterns and Outcomes of Retrievable Vena Cava Filters in Trauma Patients: An AAST Multicenter Study</title><author>Karmy-Jones, Riyad ; Jurkovich, Gregory J. ; Velmahos, George C. ; Burdick, Thomas ; Spaniolas, Konstantinos ; Todd, Samuel R. ; McNally, Michael ; Jacoby, Robert C. ; Link, Daniel ; Janczyk, Randy J. ; Ivascu, Felicia A. ; McCann, Michael ; Obeid, Farouck ; Hoff, William S. ; McQuay, Nathaniel ; Tieu, Brandon H. ; Schreiber, Martin A. ; Nirula, Ram ; Brasel, Karen ; Dunn, Julie A. ; Gambrell, Debbie ; Huckfeldt, Roger ; Harper, Jayna ; Schaffer, Kathryn B. ; Tominaga, Gail T. ; Vinces, Fausto Y. ; Sperling, David ; Hoyt, David ; Coimbra, Raul ; Rosengart, Mathew R. ; Forsythe, Raquel ; Cothren, Clay ; Moore, Ernest E. ; Haut, Elliott R. ; Hayanga, Awori J. ; Hird, Linda ; White, Christopher ; Grossman, Jodi ; Nagy, Kimberly ; Livaudais, West ; Wood, Rhonda ; Zengerink, Imme ; Kortbeek, John B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4142-f18dd96c5003c8a5a509411d82c89c7871ba5a040f5faf2a93e2aabb28f444513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Device Removal</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Postoperative Complications - epidemiology</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Pulmonary Embolism - etiology</topic><topic>Pulmonary Embolism - prevention & control</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><topic>Vena Cava Filters - adverse effects</topic><topic>Vena Cava Filters - utilization</topic><topic>Wounds and Injuries - complications</topic><topic>Wounds and Injuries - surgery</topic><toplevel>online_resources</toplevel><creatorcontrib>Karmy-Jones, Riyad</creatorcontrib><creatorcontrib>Jurkovich, Gregory J.</creatorcontrib><creatorcontrib>Velmahos, George C.</creatorcontrib><creatorcontrib>Burdick, Thomas</creatorcontrib><creatorcontrib>Spaniolas, Konstantinos</creatorcontrib><creatorcontrib>Todd, Samuel R.</creatorcontrib><creatorcontrib>McNally, Michael</creatorcontrib><creatorcontrib>Jacoby, Robert C.</creatorcontrib><creatorcontrib>Link, Daniel</creatorcontrib><creatorcontrib>Janczyk, Randy J.</creatorcontrib><creatorcontrib>Ivascu, Felicia A.</creatorcontrib><creatorcontrib>McCann, Michael</creatorcontrib><creatorcontrib>Obeid, Farouck</creatorcontrib><creatorcontrib>Hoff, William S.</creatorcontrib><creatorcontrib>McQuay, Nathaniel</creatorcontrib><creatorcontrib>Tieu, Brandon H.</creatorcontrib><creatorcontrib>Schreiber, Martin A.</creatorcontrib><creatorcontrib>Nirula, Ram</creatorcontrib><creatorcontrib>Brasel, Karen</creatorcontrib><creatorcontrib>Dunn, Julie A.</creatorcontrib><creatorcontrib>Gambrell, Debbie</creatorcontrib><creatorcontrib>Huckfeldt, Roger</creatorcontrib><creatorcontrib>Harper, Jayna</creatorcontrib><creatorcontrib>Schaffer, Kathryn B.</creatorcontrib><creatorcontrib>Tominaga, Gail T.</creatorcontrib><creatorcontrib>Vinces, Fausto Y.</creatorcontrib><creatorcontrib>Sperling, David</creatorcontrib><creatorcontrib>Hoyt, David</creatorcontrib><creatorcontrib>Coimbra, Raul</creatorcontrib><creatorcontrib>Rosengart, Mathew R.</creatorcontrib><creatorcontrib>Forsythe, Raquel</creatorcontrib><creatorcontrib>Cothren, Clay</creatorcontrib><creatorcontrib>Moore, Ernest E.</creatorcontrib><creatorcontrib>Haut, Elliott R.</creatorcontrib><creatorcontrib>Hayanga, Awori J.</creatorcontrib><creatorcontrib>Hird, Linda</creatorcontrib><creatorcontrib>White, Christopher</creatorcontrib><creatorcontrib>Grossman, Jodi</creatorcontrib><creatorcontrib>Nagy, Kimberly</creatorcontrib><creatorcontrib>Livaudais, West</creatorcontrib><creatorcontrib>Wood, Rhonda</creatorcontrib><creatorcontrib>Zengerink, Imme</creatorcontrib><creatorcontrib>Kortbeek, John B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of trauma</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karmy-Jones, Riyad</au><au>Jurkovich, Gregory J.</au><au>Velmahos, George C.</au><au>Burdick, Thomas</au><au>Spaniolas, Konstantinos</au><au>Todd, Samuel R.</au><au>McNally, Michael</au><au>Jacoby, Robert C.</au><au>Link, Daniel</au><au>Janczyk, Randy J.</au><au>Ivascu, Felicia A.</au><au>McCann, Michael</au><au>Obeid, Farouck</au><au>Hoff, William S.</au><au>McQuay, Nathaniel</au><au>Tieu, Brandon H.</au><au>Schreiber, Martin A.</au><au>Nirula, Ram</au><au>Brasel, Karen</au><au>Dunn, Julie A.</au><au>Gambrell, Debbie</au><au>Huckfeldt, Roger</au><au>Harper, Jayna</au><au>Schaffer, Kathryn B.</au><au>Tominaga, Gail T.</au><au>Vinces, Fausto Y.</au><au>Sperling, David</au><au>Hoyt, David</au><au>Coimbra, Raul</au><au>Rosengart, Mathew R.</au><au>Forsythe, Raquel</au><au>Cothren, Clay</au><au>Moore, Ernest E.</au><au>Haut, Elliott R.</au><au>Hayanga, Awori J.</au><au>Hird, Linda</au><au>White, Christopher</au><au>Grossman, Jodi</au><au>Nagy, Kimberly</au><au>Livaudais, West</au><au>Wood, Rhonda</au><au>Zengerink, Imme</au><au>Kortbeek, John B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Practice Patterns and Outcomes of Retrievable Vena Cava Filters in Trauma Patients: An AAST Multicenter Study</atitle><jtitle>The journal of trauma</jtitle><addtitle>J Trauma</addtitle><date>2007-01</date><risdate>2007</risdate><volume>62</volume><issue>1</issue><spage>17</spage><epage>25</epage><pages>17-25</pages><issn>0022-5282</issn><eissn>1529-8809</eissn><abstract>BACKGROUND:The purpose of this study is to describe practice patterns and outcomes of posttraumatic retrievable inferior vena caval filters (R-IVCF).
METHODS:A retrospective review of R-IVCFs placed during 2004 at 21 participating centers with follow up to July 1, 2005 was performed. Primary outcomes included major complications (migration, pulmonary embolism [PE], and symptomatic caval occlusion) and reasons for failure to retrieve.
RESULTS:Of 446 patients (69% male, 92% blunt trauma) receiving R-IVCFs, 76% for prophylactic indications and 79% were placed by interventional radiology. Excluding 33 deaths, 152 were Gunter-Tulip (G-T), 224 Recovery (R), and 37 Optease (Opt). Placement occurred 6 ± 8 days after admission and retrieval at 50 ± 61 days. Follow up after discharge (5.7 ± 4.3 months) was reported in 51%. Only 22% of R-IVCFs were retrieved. Of 115 patients in whom retrieval was attempted, retrieval failed as a result of technical issues in 15 patients (10% of G-T, 14% of R, 27% of Opt) and because of significant residual thrombus within the filter in 10 patients (6% of G-T, 4% of R, 46% Opt). The primary reason R-IVCFs were not removed was because of loss to follow up (31%), which was sixfold higher (6% to 44%, p = 0.001) when the service placing the R-IVCF was not directly responsible for follow up. Complications did not correlate with mechanism, injury severity, service placing the R-IVCF, trauma volume, use of anticoagulation, age, or sex. Three cases of migration were recorded (all among R, 1.3%), two breakthrough PE (G-T 0.6% and R 0.4%) and six symptomatic caval occlusions (G-T 0, R 1%, Opt 11%) (p < 0.05 Opt versus both G-T and R).
CONCLUSION:Most R-IVCFs are not retrieved. The service placing the R-IVCF should be responsible for follow up. The Optease was associated with the greatest incidence of residual thrombus and symptomatic caval occlusion. The practice patterns of R-IVCF placement and retrieval should be re-examined.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>17215729</pmid><doi>10.1097/TA.0b013e31802dd72a</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-5282 |
| ispartof | The journal of trauma, 2007-01, Vol.62 (1), p.17-25 |
| issn | 0022-5282 1529-8809 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_68418291 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Device Removal Female Humans Male Postoperative Complications - epidemiology Practice Patterns, Physicians' - statistics & numerical data Pulmonary Embolism - etiology Pulmonary Embolism - prevention & control Retrospective Studies Treatment Outcome United States - epidemiology Vena Cava Filters - adverse effects Vena Cava Filters - utilization Wounds and Injuries - complications Wounds and Injuries - surgery |
| title | Practice Patterns and Outcomes of Retrievable Vena Cava Filters in Trauma Patients: An AAST Multicenter Study |
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