Developments in Endovascular and Endoscopic SurgeryRetrievable Inferior Vena Cava Filters: Initial Clinical Results
Section snippets
INTRODUCTION
Anticoagulation is the accepted therapy for patients with venous thromboembolic disease. When contraindications to anticoagulant therapy are present, however, interruption of the inferior vena cava (IVC) can be performed to prevent pulmonary embolism (PE) as >80% of pulmonary emboli originate in the lower extremities and pelvis.1
During the past few decades, a wide variety of permanent IVC filters (IVCFs) designed for percutaneous insertion have been developed. The accepted indications for IVCF
Retrievable IVCFs
Currently, there are three retrievable IVCFs that are approved by the FDA. These filters can be used either permanently or temporarily with subsequent retrieval for PE prevention. They include the Günther-Tulip filter (Cook, Bloomington, IN), the Recovery filter (Bard Peripheral Vascular, Tempe, AZ), and the OptEase filter (Cordis Endovascular, Miami Lakes, FL).
RESULTS
Between December 1, 2002 and December 31, 2004, 127 multiple-trauma patients underwent ICU bedside placement of retrievable IVCFs. One hundred seventeen IVCFs were placed via the right femoral vein and 10 via the left femoral vein. The mean (± SD) age of the patients was 42 ± 2 years (range 17–68), and 77 (60.6%) were male. All patients sustained multiple-trauma injuries (Table I), and the mean (± SD) Injury Severity Score was 27.2 ± 2.2. One hundred thirteen (88.9%) patients had blunt injuries
DISCUSSION
Concerns regarding the long-term safety of permanent IVCFs in young patients and in patients who require short-term PE prophylaxis have created significant clinical interest in using retrievable IVCFs to provide temporary protection against PE.
Three retrievable IVCFs are approved by the FDA: the Günther-Tulip filter, the Recovery filter, and the OptEase filter. A major advantage of using a retrievable IVCF is that it may be removed once DVT intervention is initiated and the patient no longer
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SECTION EDITOR: Samuel S. Ahn, MD