Early experience with retrievable inferior vena cava filters in high-risk trauma patients.

Authors

William S Hoff
Brian A Hoey
Gail A Wainwright
James F Reed
David S Ball
Michael Ringold
Michael D Grossman

Publication/Presentation Date

12-1-2004

Abstract

BACKGROUND: This study describes the use of retrievable IVC filters in a select group of trauma patients at high risk for deep vein thrombosis (DVT) and pulmonary embolism (PE).

STUDY DESIGN: Retrievable IVC filters were placed in selected trauma patients who met high-risk criteria for deep vein thrombosis and PE according to institutional clinical management guidelines. All filters were placed percutaneously in the interventional radiology suite. Indications for filter placement were based on injury complex, weight-bearing status, and contraindications to enoxaparin or pneumatic compression devices. IVC filters were either removed or maintained.

RESULTS: Retrievable IVC filters were placed in 35 patients after blunt trauma. Twenty-six patients (74%) sustained at least one orthopaedic injury; 17 patients (49%) were diagnosed with a pelvis fracture. Activity was limited to bed rest or spinal precautions in 18 patients (51%). Enoxaparin was contraindicated in 32 patients (91%) and injuries precluded the use of pneumatic compression devices in 11 (31%). IVC filters were removed in 18 patients (51%), with no reported complications. Patients with orthopaedic injuries and pelvis fractures were less likely to have their filters maintained (p = 0.040).

CONCLUSIONS: Retrievable IVC filters offer a versatile option for prophylaxis in trauma patients at high risk for PE. Filter retrieval potentially spares the longterm complications of permanent filters in younger trauma patients. Retrievable filters warrant consideration in patients who meet high-risk criteria for deep vein thrombosis or PE who cannot receive effective mechanical prophylaxis and in whom contraindications to anticoagulation are expected to be temporary.

Volume

199

Issue

6

First Page

869

Last Page

874

ISSN

1072-7515

Published In/Presented At

Hoff, W. S., Hoey, B. A., Wainwright, G. A., Reed, J. F., Ball, D. S., Ringold, M., & Grossman, M. D. (2004). Early experience with retrievable inferior vena cava filters in high-risk trauma patients. Journal of the American College of Surgeons, 199(6), 869–874. https://doi.org/10.1016/j.jamcollsurg.2004.07.030

Disciplines

Medicine and Health Sciences

PubMedID

15555969

Department(s)

Department of Medicine

Document Type

Article