Temporary inferior vena cava filter for deep vein thrombosis and acute pulmonary thromboembolism: effectiveness and indication

Although the temporary inferior vena cava filter (IVC-F) is being used increasingly for protection against pulmonary thromboembolism (PTE), indications for its use are not established. Our strategy for the prevention of PTE is: (1) contraindication or failure of anticoagulation: permanent IVC-F; (2)...

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Veröffentlicht in:Heart and vessels 2006-07, Vol.21 (4), p.221-225
Hauptverfasser: Kai, Ryuichi, Imamura, Hiroshi, Kumazaki, Setuo, Kamiyoshi, Yuichi, Koshikawa, Megumi, Hanaoka, Takeshi, Kogashi, Kaoru, Koyama, Jun, Tsutsui, Hiroshi, Yazaki, Yoshikazu, Kinoshita, Osamu, Ikeda, Uichi
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container_end_page 225
container_issue 4
container_start_page 221
container_title Heart and vessels
container_volume 21
creator Kai, Ryuichi
Imamura, Hiroshi
Kumazaki, Setuo
Kamiyoshi, Yuichi
Koshikawa, Megumi
Hanaoka, Takeshi
Kogashi, Kaoru
Koyama, Jun
Tsutsui, Hiroshi
Yazaki, Yoshikazu
Kinoshita, Osamu
Ikeda, Uichi
description Although the temporary inferior vena cava filter (IVC-F) is being used increasingly for protection against pulmonary thromboembolism (PTE), indications for its use are not established. Our strategy for the prevention of PTE is: (1) contraindication or failure of anticoagulation: permanent IVC-F; (2) for patients with residual proximal deep vein thrombosis (a) who have permanent risk factor: permanent IVC-F; (b) who have transient risk factor: temporary IVC-F; (3) others: no IVC-F. Temporary IVC-F was also implanted in deep vein thrombosis (DVT) patients without PTE who were preoperation or had floating thrombus. We investigated the outcome of patients given a temporary IVC-F versus those given a permanent IVC-F to clarify the efficacy and our strategy for implantation of a temporary IVC-F. Subjects were 12 men and 38 women with acute PTE and/or floating DVT admitted to our hospital between April 1999 and April 2002. Patient age was 25-91 years (mean 63 years). Eighteen patients were given a permanent IVC-F (group A) and 32 patients were given a temporary IVC-F (group B) as primary treatment, according to our criteria. There were no major complications in either group. Mortality after implantation of the IVC-F was 35% (6/17) in group A and 16% (4/25) in group B, with no significant difference (P = 0.14). Pulmonary thromboembolism recurred in 18% (3/17) of group A patients but in no group B patients (P = 0.10). All recurrences resulted in death. The 14 patients in group B who were not given a permanent IVC-F after removal of the temporary IVC-F survived. The temporary IVC-F can be used safely in patients with venous thromboembolism and is efficacious in preventing recurrence of PTE. Prognosis after removal of the temporary IVC-F is excellent.
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Our strategy for the prevention of PTE is: (1) contraindication or failure of anticoagulation: permanent IVC-F; (2) for patients with residual proximal deep vein thrombosis (a) who have permanent risk factor: permanent IVC-F; (b) who have transient risk factor: temporary IVC-F; (3) others: no IVC-F. Temporary IVC-F was also implanted in deep vein thrombosis (DVT) patients without PTE who were preoperation or had floating thrombus. We investigated the outcome of patients given a temporary IVC-F versus those given a permanent IVC-F to clarify the efficacy and our strategy for implantation of a temporary IVC-F. Subjects were 12 men and 38 women with acute PTE and/or floating DVT admitted to our hospital between April 1999 and April 2002. Patient age was 25-91 years (mean 63 years). Eighteen patients were given a permanent IVC-F (group A) and 32 patients were given a temporary IVC-F (group B) as primary treatment, according to our criteria. 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subjects Aged
Blood clots
Cardiovascular disease
Clinical outcomes
Female
Humans
Male
Medical equipment
Middle Aged
Pulmonary Embolism - mortality
Pulmonary Embolism - prevention & control
Secondary Prevention
Transplants & implants
Vena Cava Filters
Venous Thrombosis - therapy
title Temporary inferior vena cava filter for deep vein thrombosis and acute pulmonary thromboembolism: effectiveness and indication
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