Inferior Vena Cava Filters

ABSTRACT

Venous thromboembolism (VTE) remains a common disease with significant clinical impact upon our patients. Diagnostic challenges occur because of the nonspecific nature of the presenting symptoms. The advent of multidetector computed tomography, methods to stratify patients into VTE risks (low, intermediate, high) along with serological assays (D-dimers), have helped direct patients through proper workup and into conclusive diagnosis. In most cases, standard medical therapy for VTE is anticoagulation therapy (OAT). In situations where standard OAT is either contraindicated or complications result from that therapy, insertion of inferior vena cava (IVC) filters is considered. Recent reports suggest that although IVC filters are able to prevent pulmonary emboli (PE) in the short and intermediate term, there appear to be long-term consequences including excess recurrent deep venous thombosis (DVT and IVC/filter occlusions). Recognition of the time sequence of IVC filter benefits and complications has encouraged development of optional IVC filters, which can be left in place indefinitely or removed usually before certain time constraints. This article will attempt to address the timing of IVC filter placements to protect patients from significant PE.

KEYWORDS

Venous - thrombosis - embolism - pulmonary - venae cavai - filters

REFERENCES

• 1 White R H. The epidemiology of venous thromboembolism.  Circulation. 2003;  107 I4-I8
• 2 Barritt D W, Jordan S C. Anticoagulant drugs in treatment of pulmonary embolisms: a controlled clinical trail.  Lancet. 1960;  1 1309-1312
• 3 Levine M, Raskob G E, Landefeld C S, Kearnon C. Hemorrhage complications after anticoagulation treatment.  Chest. 1998;  114(suppl) 511S-523S
• 4 Kinney T B. Update on inferior vena cava filters.  J Vasc Interv Radiol. 2003;  14 425-430
• 5 Greenfield L J. Evolution of venous interruption for pulmonary thromboembolism.  Arch Surg. 1992;  127 622-626
• 6 Greenfield L J, McCrudy J R, Brown P P, Elkins R S. A new intracaval filter permitting continued flow and resolution of emboli.  Surgery. 1973;  73 599-606
• 7 Becker D M, Philbrick J T, Selby J B. Inferior vena cava filters.  Arch Intern Med. 1992;  152 1985-1994
• 8 Streiff M B. Vena caval filters: a comprehensive review.  Blood. 2000;  95 3669-3677
• 9 Girard P, Stern J P, Parent F. Medical literature and vena cava filters: so far so weak.  Chest. 2002;  122 963-967
• 10 Brender E. Use of emboli-blocking filters increases, but rigorous data are lacking.  JAMA. 2006;  295 989-990
• 11 Decousus H, Leizorovicz A, Parent A 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
• 12 The PREPIC study group . Eight year follow-up of patients with permanent vena cava filters in prevention of pulmonary embolism. The PREPIC (Prévention Du Risque D'Embolie Pulmonaire par Interruption Cave) Randomized Study.  Circulation. 2005;  112 416-422
• 13 Girard P, Musset D, Parent F, Maitre S, Philippoteau C, Simonneau G. High prevalence of detectable deep venous thrombosis in patients with acute pulmonary embolism.  Chest. 1999;  116 903-908
• 14 Hyers T M. Management of venous thromboembolism: past, present, and future.  Arch Intern Med. 2003;  163 759-768
• 15 Barritt D W, Jordan S C. Anticoagulant drugs in treatment of pulmonary embolism: a controlled trial.  Lancet. 1960;  1 1309-1312
• 16 Cundiff D K, Manyemba J, Pezzullo J C. Anticoagulants versus non-steroidal anti-inflammatories or placebo for treatment of venous thromboembolism.  Cochrane Database Syst Rev. 2006;  (1) CD003746
• 17 Douketis J D, Kearon C, Bates S et al.. Risk of fatal pulmonary embolism in patients with treated venous thromboembolism.  JAMA. 1998;  279 458-462
• 18 Heit J A. Venous thromboembolism: disease burden, outcomes and risk factors.  J Thromb Haemost. 2005;  3 1611-1617
• 19 Palareti G, Manotti C, D'Angelo A et al.. Thrombotic events during oral anticoagulation treatment: results of inception-cohort, prospective, collaborative ISCOAT study.  Thromb Haemost. 1997;  78 1438-1443
• 20 Kaufman J, Kinney T B, Streiff M B et al.. Guidelines for the use of retrievable and convertible vena cava filters: report for the SIR multidisciplinary consensus conference.  J Vasc Interv Radiol. 2006;  17 449-459
• 21 Jones T K, Barnes R W, Greenfield L J. Greenfield vena caval filter: rationale and current indications.  Ann Thorac Surg. 1986;  42(suppl) S48-S55
• 22 Barker N W, Nygaard K K, Walters W, Priestly J T. A statistical study of postoperative venous thrombosis and pulmonary embolism: III. Time of occurrence during the post operative period.  Proc Staff Mayo Clin. 1941;  16 17-21
• 23 Norris C S, Greenfield L J, Herrmann J B. Free-floating iliofemoral thrombus.  Arch Surg. 1985;  120 806-808
• 24 Pacouret G, Alison D, Pottier J M, Bertrand P, Charbonnier B. Free-floating thrombus and embolic risk with angiographically confirmed proximal deep venous thrombus: a prospective study.  Arch Intern Med. 1997;  157 305-308
• 25 Dalen J E, Alpert J S. Natural history of pulmonary embolism.  Prog Cardiovasc Dis. 1975;  17 259-270
• 26 Greenfield L J, Peyton M D, Brown P P, Elkins R C. Transvenous management of pulmonary embolic disease.  Ann Surg. 1974;  180 461-468
• 27 The urokinase pulmonary embolism trial: a national cooperative study.  Circulation. 1973;  47(suppl 2) II1-II108
• 28 Greenfield L J, Scher L A, Elkins R C. KMA-Greenfield filter placement for chronic pulmonary hypertension.  Ann Surg. 1979;  189 560-565
• 29 Peyton J W, Hylemon M B, Greenfield L J et al.. Comparison of Greenfield filter and vena cava ligation for experimental septic thromboembolism.  Surgery. 1983;  93 533-537
• 30 Greenfield L J, Proctor M C. Vena cava filter use in patients with sepsis: results in 175 patients.  Arch Surg. 2003;  138 1245-1248
• 31 Shimizu M, Tatsumi K, Matsukawa R, Shima T, Miwa Y. Retrievable Günther Tulip filter complicated by sepsis and retroperitoneal hemorrhage: successful management by filter retrieval.  Intern Med. 2005;  44 593-597
• 32 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
• 33 Moore B S, Valji K, Roberts A C, Bookstein J J. Transcatheter manipulation of asymmetrically opened Greenfield filters.  J Vasc Interv Radiol. 1993;  4 687-690
• 34 Greenfield L J, Proctor M C. Experimental embolic capture by asymmetric Greenfield filters.  J Vasc Surg. 1992;  16 436-465
• 35 Kinney T B, Rose S C, Weingarten K E et al.. IVC filter tilt and asymmetry: comparison of the over-the-wire stainless steel and titanium Greenfield IVC filters.  J Vasc Interv Radiol. 1997;  8 1029-1037
• 36 David W, Gross W S, Colaiuta E, Gonda R, Osher D, Launti S. Pulmonary embolus after vena cava filter placement.  Am Surg. 1999;  65 341-346
• 37 Rogers F B, Cipolle M D, Velmahos G, Royzyki G, Luchette F A. Practice management guidelines for prevention of venous thromboembolism in trauma patients: the EAST practice management guidelines work group.  J Trauma. 2002;  53 142-164
• 38 Lorch H, Zwaan M, Siemens H J, Wagner T, Kagel C, Weiss H D. Temporary vena cava filters and ultrahigh streptokinase thrombolysis therapy: a clinical study.  Cardiovasc Intervent Radiol. 2000;  23 273-278
• 39 Grimm W, Schwieder G, Wagner T. Fatal pulmonary embolism in venous thrombosis of the leg and pelvis during lysis therapy.  Dtsch Med Wochenschr. 1990;  115 1183-1187
• 40 Semba C P, Cake M D. Iliofemoral deep venous thrombosis: aggressive therapy with catheter-directed thrombolysis.  Radiology. 1994;  191 487-494
• 41 Jamieson S W, Nomura K. Indications for and the results of pulmonary thromboendarterectomy for thromboembolic pulmonary hypertension.  Semin Vasc Surg. 2000;  13 236-244