Optional Inferior Vena Cava Filters in the Trauma Patient

ABSTRACT

Trauma patients are at exceedingly high risk of development of venous thromboembolism (VTE) including deep venous thrombosis and pulmonary embolism (PE). The epidemiology of VTE in trauma patients is reviewed. PE is thought to be the third major cause of death after trauma in those patients who survive longer than 24 hours after onset of injury. In fact, patients recovering from trauma have the highest rate of VTE among all subgroups of hospitalized patients. Various prophylactic and surveillance methods have been evaluated and found helpful in certain situations, but VTE complications can occur despite such measures. Therapeutic and prophylactic uses of inferior vena cava (IVC) filters in trauma patients are reviewed. Prophylactic IVC filter use is revealed to be a controversial subject with valid arguments on both sides of the issue. With the lack of prospective randomized trials of IVC filter use in trauma, it is impossible to make evidence-based recommendations. Unfortunately, two sets of guidelines are available for insertion of filters in trauma patients, with conflicting recommendations. The introduction of retrievable IVC filters seems to offer a unique solution for VTE protection in the trauma patient population, which often consists of younger members of our population. Lastly, current generations of FDA-approved retrieval filters are discussed.

Venous thromboembolism - inferior vena cava filter - trauma

REFERENCES

• 1 Shackford S R, Davis J W, Hollingsworth-Fridlund P et al.. Venous thromboembolism in patients with major trauma.  Am J Surg. 1990;  159 365-369
• 2 McCartney J. Pulmonary embolism following trauma.  Surg Gynecol Obstet. 1935;  61 369-379
• 3 Sevitt S, Gallagher N. Venous thrombosis and pulmonary embolism. A clinico-pathological study in injured and burned patients.  Br J Surg. 1961;  48 475-489
• 4 Sevitt S, Gallagher N G. Prevention of venous thrombosis and pulmonary embolism in injured patients. A trial of anticoagulant prophylaxis with phenindione in middle-aged and elderly patients with fractured necks of femur.  Lancet. 1959;  2 981-989
• 5 Fitts Jr W T, Lehr H B, Bitner R L, Spelman J W. An analysis of 950 fatal injuries.  Surgery. 1964;  56 663-668
• 6 Coon W W. Risk factors in pulmonary embolism.  Surg Gynecol Obstet. 1976;  143 385-390
• 7 Knudson M M, Collins J A, Goodman S B, McCrory D W, Hoyt D B, Mackersie R C. Thromboembolism following multiple trauma.  J Trauma. 1992;  32 2-11
• 8 Geerts W H, Code K I, Jay R M, Chen E, Szalai J P. A prospective study of venous thromboembolism after major trauma.  N Engl J Med. 1994;  331 1601-1606
• 9 Adams R C, Hamrick M, Berenguer C, Senkowski C, Ochsner M G. Four years of an aggressive prophylaxis and screening protocol for venous thromboembolism in a large trauma population.  J Trauma. 2008;  65 300-306 discussion 306-308
• 10 Knudson M M, Ikossi D G. Venous thromboembolism after trauma.  Curr Opin Crit Care. 2004;  10 539-548
• 11 Rogers F B. Venous thromboembolism in trauma patients: a review.  Surgery. 2001;  130 1-12
• 12 Dennis J W, Menawat S, Von Thron J et al.. Efficacy of deep venous thrombosis prophylaxis in trauma patients and identification of high-risk groups.  J Trauma. 1993;  35 132-138 discussion 138-139
• 13 Velmahos G C, Kern J, Chan L S, Oder D, Murray J A, Shekelle P. Prevention of venous thromboembolism after injury: an evidence-based report—part I: analysis of risk factors and evaluation of the role of vena caval filters.  J Trauma. 2000;  49 132-138 discussion 139
• 14 Rogers F B, Cipolle M D, Velmahos G, Rozycki G, Luchette F A. Practice management guidelines for the prevention of venous thromboembolism in trauma patients: the EAST practice management guidelines work group.  J Trauma. 2002;  53 142-164
• 15 Jacobs D G, Piotrowski J J, Hoppensteadt D A, Salvator A E, Fareed J. Hemodynamic and fibrinolytic consequences of intermittent pneumatic compression: preliminary results.  J Trauma. 1996;  40 710-716 discussion 716-717
• 16 Hoff W S, Hoey B A, Wainwright G A et al.. Early experience with retrievable inferior vena cava filters in high-risk trauma patients.  J Am Coll Surg. 2004;  199 869-874
• 17 Bjarnason H. Commentary on “Retrievable IVC filters: a decision matrix for appropriate utilization”.  Perspect Vasc Surg Endovasc Ther. 2006;  18 17-18
• 18 Rogers F, Rebuck J A, Sing R F. Venous thromboembolism in trauma: an update for the intensive care unit practitioner.  J Intensive Care Med. 2007;  22 26-37
• 19 Fullen W D, Miller E H, Steele W F, McDonough J J. Prophylactic vena caval interruption in hip fractures.  J Trauma. 1973;  13 403-410
• 20 Thomas III W O, Ferrara J J, Rodning C B. A retrospective analysis of inferior vena caval filtration for prevention of pulmonary embolization.  Am Surg. 1988;  54 726-730
• 21 Rohrer M J, Scheidler M G, Wheeler H B, Cutler B S. Extended indications for placement of an inferior vena cava filter.  J Vasc Surg. 1989;  10 44-49 discussion 49-50
• 22 Webb L X, Rush P T, Fuller S B, Meredith J W. Greenfield filter prophylaxis of pulmonary embolism in patients undergoing surgery for acetabular fracture.  J Orthop Trauma. 1992;  6 139-145
• 23 Wilson J T, Rogers F B, Wald S L, Shackford S R, Ricci M A. Prophylactic vena cava filter insertion in patients with traumatic spinal cord injury: preliminary results.  Neurosurgery. 1994;  35 234-239 discussion 239
• 24 Rosenthal D, McKinsey J F, Levy A M, Lamis P A, Clark M D. Use of the Greenfield filter in patients with major trauma.  Cardiovasc Surg. 1994;  2 52-55
• 25 Winchell R J, Hoyt D B, Walsh J C, Simons R K, Eastman A B. Risk factors associated with pulmonary embolism despite routine prophylaxis: implications for improved protection.  J Trauma. 1994;  37 600-606
• 26 Leach T A, Pastena J A, Swan K G, Tikellis J I, Blackwood J M, Odom J W. Surgical prophylaxis for pulmonary embolism.  Am Surg. 1994;  60 292-295
• 27 Khansarinia S, Dennis J W, Veldenz H C, Butcher J L, Hartland L. Prophylactic Greenfield filter placement in selected high-risk trauma patients.  J Vasc Surg. 1995;  22 231-235 discussion 235-236
• 28 Rogers F B, Shackford S R, Ricci M A, Wilson J T, Parsons S. Routine prophylactic vena cava filter insertion in severely injured trauma patients decreases the incidence of pulmonary embolism.  J Am Coll Surg. 1995;  180 641-647
• 29 Patton Jr J H, Fabian T C, Croce M A, Minard G, Pritchard F E, Kudsk K A. Prophylactic Greenfield filters: acute complications and long-term follow-up.  J Trauma. 1996;  41 231-236 discussion 236-237
• 30 Rodriguez J L, Lopez J M, Proctor M C et al.. Early placement of prophylactic vena caval filters in injured patients at high risk for pulmonary embolism.  J Trauma. 1996;  40 797-802 discussion 802-804
• 31 Nunn C R, Neuzil D, Naslund T et al.. Cost-effective method for bedside insertion of vena caval filters in trauma patients.  J Trauma. 1997;  43 752-758
• 32 Gosin J S, Graham A M, Ciocca R G, Hammond J S. Efficacy of prophylactic vena cava filters in high-risk trauma patients.  Ann Vasc Surg. 1997;  11 100-105
• 33 Headrick Jr J R, Barker D E, Pate L M, Horne K, Russell W L, Burns R P. The role of ultrasonography and inferior vena cava filter placement in high-risk trauma patients.  Am Surg. 1997;  63 1-8
• 34 Rogers F B, Shackford S R, Ricci M A, Huber B M, Atkins T. Prophylactic vena cava filter insertion in selected high-risk orthopaedic trauma patients.  J Orthop Trauma. 1997;  11 267-272
• 35 Rogers F B, Strindberg G, Shackford S R et al.. Five-year follow-up of prophylactic vena cava filters in high-risk trauma patients.  Arch Surg. 1998;  133 406-411 discussion 412
• 36 Langan 3rd E M, Miller R S, Casey 3rd W J, Carsten 3rd C G, Graham R M, Taylor S M. Prophylactic inferior vena cava filters in trauma patients unable to receive standard venous thromboembolism prophylaxis.  J Vasc Surg. 1999;  30 484-488
• 37 Hughes G C, Smith T P, Eachempati S R, Vaslef S N, Reed II R L. The use of a temporary vena caval interruption device in high-risk trauma patients unable to receive standard venous thromboembolism prophylaxis.  J Trauma. 1999;  46 246-249
• 38 McMurtry A L, Owings J T, Anderson J T, Battistella F D, Gosselin R. Increased use of prophylactic vena cava filters in trauma patients failed to decrease overall incidence of pulmonary embolism.  J Am Coll Surg. 1999;  189 314-320
• 39 Wojcik R, Cipolle M D, Fearen I, Jaffe J, Newcomb J, Pasquale M D. Long-term follow-up of trauma patients with a vena caval filter.  J Trauma. 2000;  49 839-843
• 40 Sekharan J, Dennis J W, Miranda F E et al.. Long-term follow-up of prophylactic Greenfield filters in multisystem trauma patients.  J Trauma. 2001;  51 1087-1090 discussion 1090-1091
• 41 Rosenthal D, Wellons E D, Levitt A B, Shuler F W, O’Conner R E, Henderson V J. 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. 2004;  40 958-964
• 42 Morris C S, Rogers F B, Najarian K E, Bhave A D, Shackford S R. Current trends in vena caval filtration with the introduction of a retrievable filter at a level I trauma center.  J Trauma. 2004;  57 32-36
• 43 Allen T L, Carter J L, Morris B J, Harker C P, Stevens M H. Retrievable vena cava filters in trauma patients for high-risk prophylaxis and prevention of pulmonary embolism.  Am J Surg. 2005;  189 656-661
• 44 Antevil J L, Sise M J, Sack D I et al.. Retrievable vena cava filters for preventing pulmonary embolism in trauma patients: a cautionary tale.  J Trauma. 2006;  60 35-40
• 45 Meier C, Keller I S, Pfiffner R, Labler L, Trentz O, Pfammatter T. Early experience with the retrievable OptEase vena cava filter in high-risk trauma patients.  Eur J Vasc Endovasc Surg. 2006;  32 589-595
• 46 Rosenthal D, Wellons E D, Lai K M, Bikk A, Henderson V J. Retrievable inferior vena cava filters: initial clinical results.  Ann Vasc Surg. 2006;  20 157-165
• 47 Karmy-Jones R, Jurkovich G J, Velmahos G C et al.. Practice patterns and outcomes of retrievable vena cava filters in trauma patients: an AAST multicenter study.  J Trauma. 2007;  62 17-24 discussion 24-25
• 48 Cherry R A, Nichols P A, Snavely T M, David M T, Lynch F C. Prophylactic inferior vena cava filters: do they make a difference in trauma patients?.  J Trauma. 2008;  65 544-548
• 49 Johnson III O N, Gillespie D L, Aidinian G, White P W, Adams E, Fox C J. The use of retrievable inferior vena cava filters in severely injured military trauma patients.  J Vasc Surg. 2009;  49 410-416 discussion 416
• 50 Decousus H, Leizorovicz A, Parent F et al.. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prévention du Risque d’Embolie Pulmonaire par Interruption Cave Study Group.  N Engl J Med. 1998;  338 409-415
• 51 PREPIC Study Group . Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC (Prevention du Risque d’Embolie Pulmonaire par Interruption Cave) randomized study.  Circulation. 2005;  112 416-422
• 52 Velmahos G C, Kern J, Chan L S, Oder D, Murray J A, Shekelle P. Prevention of venous thromboembolism after injury: an evidence-based report—part II: analysis of risk factors and evaluation of the role of vena caval filters.  J Trauma. 2000;  49 140-144
• 53 Girard T D, Philbrick J T, Fritz Angle J, Becker D M. Prophylactic vena cava filters for trauma patients: a systematic review of the literature.  Thromb Res. 2003;  112 261-267
• 54 Brasel K J, Borgstrom D C, Weigelt J A. Cost-effective prevention of pulmonary embolus in high-risk trauma patients.  J Trauma. 1997;  42 456-460 discussion 460-462
• 55 Spain D A, Richardson J D, Polk Jr H C, Bergamini T M, Wilson M A, Miller F B. Venous thromboembolism in the high-risk trauma patient: do risks justify aggressive screening and prophylaxis?.  J Trauma. 1997;  42 463-467 discussion 467-469
• 56 Geerts W H, Bergqvist D, Pineo G F American College of Chest Physicians et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).  Chest. 2008;  133(6 Suppl) 381S-453S
• 57 Singh P, Lai H M, Lerner R G, Chugh T, Aronow W S. Guidelines and the use of inferior vena cava filters: a review of an institutional experience.  J Thromb Haemost. 2009;  7 65-71
• 58 Oppat W F, Chiou A C, Matsumura J S. Intravascular ultrasound-guided vena cava filter placement.  J Endovasc Surg. 1999;  6 285-287
• 59 Matsuura J H, White R A, Kopchok G et al.. Vena caval filter placement by intravascular ultrasound.  Cardiovasc Surg. 2001;  9 571-574
• 60 Wellons E D, Matsuura J H, Shuler F W, Franklin J S, Rosenthal D. Bedside intravascular ultrasound-guided vena cava filter placement.  J Vasc Surg. 2003;  38 455-457
• 61 Van Natta T L, Morris Jr J A, Eddy V A et al.. Elective bedside surgery in critically injured patients is safe and cost-effective.  Ann Surg. 1998;  227 618-624 discussion 624-626
• 62 Sato D T, Robinson K D, Gregory R T et al.. Duplex directed caval filter insertion in multi-trauma and critically ill patients.  Ann Vasc Surg. 1999;  13 365-371
• 63 Danetz J S, McLafferty R B, Ayerdi J, Gruneiro L A, Ramsey D E, Hodgson K J. Selective venography versus nonselective venography before vena cava filter placement: evidence for more, not less.  J Vasc Surg. 2003;  38 928-934
• 64 Kaufman J A, Kinney T B, Streiff M B et al.. 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. 2006;  17 449-459
• 65 Schmelzer T M, Christmas A B, Taylor D A, Heniford B T, Sing R F. Vena cava filter retrieval in therapeutically anticoagulated patients.  Am J Surg. 2008;  196 944-946 discussion 946-947
• 66 Sing R F, Camp S M, Heniford B T et al.. Timing of pulmonary emboli after trauma: implications for retrievable vena cava filters.  J Trauma. 2006;  60 732-734 discussion 734-735
• 67 Van Ha T G, Vinokur O, Lorenz J et al.. Techniques used for difficult retrievals of the Günther Tulip inferior vena cava filter: experience in 32 patients.  J Vasc Interv Radiol. 2009;  20 92-99
• 68 Kuo W T, Bostaph A S, Loh C T, Frisoli J K, Kee S T. Retrieval of trapped Günther Tulip inferior vena cava filters: snare-over-guide wire loop technique.  J Vasc Interv Radiol. 2006;  17(11 Pt 1) 1845-1849
• 69 Stavropoulos S W, Dixon R G, Burke C T et al.. Embedded inferior vena cava filter removal: use of endobronchial forceps.  J Vasc Interv Radiol. 2008;  19 1297-1301
• 70 Kinney T B. Update on inferior vena cava filters.  J Vasc Interv Radiol. 2003;  14 425-440
• 71 Keeling A N, Kinney T B, Lee M J. Optional inferior vena caval filters: where are we now?.  Eur Radiol. 2008;  18 1556-1568
• 72 Rimon U, Volkov A, Garniek A et al.. Histology of tissue adherent to OptEase inferior vena cava filters regarding indwelling time.  Cardiovasc Intervent Radiol. 2009;  32 93-96