Prophylactic inferior vena cava filters prevent pulmonary embolisms in high-risk patients undergoing major spinal surgery
| Autor: | Marc Agulnick, Ryan M. Vellinga, Justin M. Dazley, Benjamin E. Cohen, Reese Wain |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Vena Cava Filters Deep vein Population Inferior vena cava Risk Factors Medicine Humans Orthopedics and Sports Medicine cardiovascular diseases Thrombus education education.field_of_study High risk patients Equipment Safety business.industry Perioperative Middle Aged medicine.disease Spinal surgery Spine Surgery Pulmonary embolism medicine.anatomical_structure Treatment Outcome medicine.vein cardiovascular system Female Neurology (clinical) business Pulmonary Embolism |
| Zdroj: | Journal of spinal disorderstechniques. 25(4) |
| ISSN: | 1539-2465 |
| Popis: | Study design Clinical case series. Objective To show the efficacy of prophylactic inferior vena cava (IVC) filters in preventing venous thromboembolic event (VTE) in high-risk patients undergoing major spinal surgery. Summary of background data Patients undergoing major spinal surgery are at increased risk for VTEs. Recent studies have shown IVC filters are effective in preventing clinically significant pulmonary embolism (PE), but have not documented the frequency of all emboli prevented. Methods Patients undergoing major spinal surgery from 2006 to 2009, having IVC filters placed for VTE prophylaxis, were reviewed. Patients with 2 or more risk factors for VTE were included and their perioperative courses were reviewed for PE and device-related complications. Cavograms obtained at the time of attempted filter retrieval identified intercepted emboli. The rates of intercepted emboli and clinical PEs were compared with those of similar populations undergoing similar procedures. Results Approximately 17% of patients had entrapped thrombus present at attempted filter retrieval. An additional 17% of filters were unable to be retrieved due to change in position within the IVC. No patients experienced symptomatic PE. One patient developed a deep vein thrombus requiring pharmacologic treatment and another patient developed superficial phlebitis. There were no complications related to IVC filter use. Conclusions These findings show that the decreased rate of PE observed in this and other series is likely because of the use of IVC filters, rather than sampling bias inherent when studying a relatively rare problem. The safety of IVC filters in this population is also confirmed. The observed rate of clinical PE is consistent with other published series. Emboli intercepted by filters may more accurately estimate clinically significant emboli prevented. Therefore, cavograms may prove to be a valuable method of assessing the efficacy of these devices in future studies. |
| Databáze: | OpenAIRE |
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