Ten-year experience of retrievable inferior vena cava filters in a tertiary referral center
| Autor: | Trevor J. Cleveland, George Tse, Stephen D. Goode |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Vena Cava Filters Vena Cava Inferior 030204 cardiovascular system & hematology Inferior vena cava 030218 nuclear medicine & medical imaging Thromboembolic prophylaxis Tertiary Care Centers 03 medical and health sciences Young Adult 0302 clinical medicine Interventional Radiology Medicine Humans Radiology Nuclear Medicine and imaging In patient Device Removal Aged Retrospective Studies Ultrasonography Aged 80 and over medicine.diagnostic_test business.industry Incidence (epidemiology) Magnetic resonance imaging Middle Aged Magnetic Resonance Imaging Surgery Treatment Outcome medicine.vein cardiovascular system Referral center Female University teaching Cardiology and Cardiovascular Medicine business Pulmonary Embolism Tomography X-Ray Computed Cancer surgery |
| Popis: | PURPOSE A significant proportion of patients undergoing surgery have an increased incidence of acute pulmonary embolus (PE). We analyzed all patients who had a retrievable inferior vena cava (IVC) filter placed preoperatively for PE prophylaxis and investigated the long-term outcomes of the patients who did not have their filter removed. METHODS Patients who underwent retrievable IVC filter insertion and attempted removal were identified from the radiology information systems database in a large tertiary referral university teaching hospital. Results of all clinical investigations (including computed tomography, magnetic resonance imaging, ultrasonography, and plain radiography) while the IVC filters were in situ were reviewed. RESULTS In total, 393 retrievable IVC filters were inserted, 254 with the indication of preoperative thromboembolic prophylaxis. Recurrent PE was reported in five patients (1.9%) despite the IVC filter. Of the 254 retrievable filters inserted prior to surgery, an attempt at retrieval was made in 168 filters (66.1%). Successful retrieval at the first attempt occurred in 143 cases (85.1%), while 25 cases failed or were aborted (14.9%). No attempt at retrieval was made in 86 (33.9%) patients and a significant proportion of these patients had undergone cancer surgery (P < 0.0107). In those patients where there was no attempt at retrieval, there was an association between cancer surgery and a shorter absolute survival time (P < 0.0001). CONCLUSION The majority of attempted filter retrievals were successful, and a proportion of nonretrieved IVC filters are accounted for in patients who underwent cancer surgery and ultimately died with the filter in situ. A departmental protocol is recommended to ensure the filter is removed where appropriate and possible. |
| Databáze: | OpenAIRE |
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