Advertisement

Indications, management, and complications of temporary inferior vena cava filters

  • Ulrich Linsenmaier
  • Johannes Rieger
  • Franz Schenk
  • Clemens Rock
  • Eugen Mangel
  • Klaus Jürgen Pfeifer
Clinical Investigations

Abstract

Purpose: We describe the results of a preliminary prospective study using different recently developed temporary and retrievable inferior vena cava (IVC) filters.

Methods: Fifty temporary IVC filters (Günther, Günther Tulip, Anthéor) were inserted in 47 patients when the required period of protection against pulmonary embolism (PE) was estimated to be less than 2 weeks. The indications were documented deep vein thrombosis (DVT) and temporary contraindications for anticoagulation, a high risk for PE, and PE despite DVT prophylaxis.

Results: Filters were removed 1–12 days after placement and nine (18%) had captured thrombi. Complications were one PE during and after removal of a filter, two minor filter migrations, and one IVC thrombosis.

Conclusion: Temporary filters are effective in trapping clots and protecting against PE, and the complication rate does not exceed that of permanent filters. They are an alternative when protection from PE is required temporarily, and should be considered in patients with a normal life expectancy.

Key words

Pulmonary embolism Caval filter, temporary and retrievable 

References

  1. 1.
    Ferris EJ, McCowan TC, Carver DK, McFarland DR (1993) Percutaneous inferior vena caval filters: Follow-up of seven designs in 320 patients. Radiology 188:851–856PubMedGoogle Scholar
  2. 2.
    Athanasoulis CA (1993) Complications of vena cava filters. Radiology 188:614–615PubMedGoogle Scholar
  3. 3.
    Orsini RA, Jarrell BE (1984) Suprarenal placement of vena caval filters: Indications, techniques, and results. J Vase Surg 1:124–135CrossRefGoogle Scholar
  4. 4.
    Rogers FB, Shackford SR, Wilson J, Ricci MA, Morris CS (1993) Prophylactic vena cava filter insertion in severely injured trauma patients: Indications and preliminary results. J Trauma 35:637–642PubMedCrossRefGoogle Scholar
  5. 5.
    Rogers FB, Shackford SR, Ricci MA, Wilson JT, Parson S (1995) Routine prophylactic vena cava filter insertion in severely injured trauma patients decreases the incidence of pulmonary embolism, (see comments) J Am Coll Surg 180:641–647. Comment in: J Am Coll Surg 1995;180:725–726. Comment in: J Am Coll Surg 1996;182:279–280PubMedGoogle Scholar
  6. 6.
    Dorfman GS (1992) Evaluating the roles and function of vena caval filters: Will data be available before or after these devices are removed from the market? Radiology 185:15–17PubMedGoogle Scholar
  7. 7.
    Millward SF, Marsh JI, Peterson RA, Rasuli P, French G, Wilson CM, Tennenhouse JE, Morris DC, Simons ME, Formoso AF (1991) LGM (Vena Tech) vena cava filter: Clinical experience in 64 patients. J Vase Interv Radiol 2:429–433CrossRefGoogle Scholar
  8. 8.
    Khansarinia S, Dennis JW, Veldenz HC, Butcher JL, Hartland L (1995) Prophylactic Greenfield filter placement in selected high-risk trauma patients, (see comments) J Vase Surg 22:231–235. Comment in: J Vase Surg 1995;22: discussion 235–236CrossRefGoogle Scholar
  9. 9.
    Darcy MD, Cardella JF, Hunter DW, Smith TP, Castaneda-Zuniga WR, Lund G, Amplatz K (1986) Experience with the Amplatz retrievable vena caval filter: Work in progress. Radiology 161:611–614PubMedGoogle Scholar
  10. 10.
    Epstein DH, Darcy MD, Hunter DW, Coleman CC, Tadavarthy SM, Murray PD, Castaneda-Zuniga WR, Amplatz K (1989) Experience with the Amplatz retrievable vena cava filter. Radiology 172:105–110PubMedGoogle Scholar
  11. 11.
    Fobbe F, Dietzel M, Korth R, Felsenberg D, Bender S, Hamed M, Laass C, Sorensen R (1988) Günther vena caval filter: Results of long-term follow-up. AJR 151:1031–1034PubMedGoogle Scholar
  12. 12.
    Neuerburg JM, Günther RW, Rassmussen E, Vorwerk D, Tonn K, Handt S, Kuepper W, Hanssen JHA (1993) New retrievable percutaneous vena cava filter: Experimental in-vitro and in-vivo evaluation. Cardiovasc Intervent Radiol 16:224–229PubMedCrossRefGoogle Scholar
  13. 13.
    Weissmann JR, Sullivan KL (1990) In-vitro assessment of clot trapping and retrieval with the temporary Günther vena cava filter. Radiology 177:310Google Scholar
  14. 14.
    Millward SF, Bormanis J, Burbridge BE, Markman SJ, Peterson RA (1994) Preliminary clinical experience with the Günther temporary inferior vena cava filter. J Vase Interv Radiol 5:863–868CrossRefGoogle Scholar
  15. 15.
    Zwaan M, Kagel C, Marienhoff N, Weiss HD (1995) First experiences with temporary vena cava filters. Rofo 163:171–176PubMedGoogle Scholar
  16. 16.
    Neuerburg JM, Günther RW, Vorwerk D, Dondelinger RF, Jaeger H, Lackner KJ, Schild HH, Plant GR, Joffre FG, Schneider PA, Janssen JHA (1997) Results of a multicenter study of the retrievable Tulip Vena Cava Filter: Early clinical experience. Cardiovasc Intervent Radiol 20:10–16PubMedCrossRefGoogle Scholar
  17. 17.
    Jaeger HJ, Mair T, Geller M, Bongert M, Kinne R, Christmann A, Mathias KD (1997) A physiologie in vitro model of the inferior vena cava with a computer-controlled flow system for testing of inferior vena cava filters. Invest Radiol 32:511–522PubMedCrossRefGoogle Scholar
  18. 18.
    Carcone B, Pernes JM, Carciopino JM, Chollet D, Pouillard F (1995) Worsening of proximal thrombosis after insertion of a temporary caval filter (3 cases). Rev Med Intern 16:351–353CrossRefGoogle Scholar
  19. 19.
    Kunisch M, Rauber K, Bachmann G, Rau WS (1995) Temporary cava filter: Effective prophylaxis of pulmonary embolism in venous thrombosis in the region of the pelvic vascular system and the inferior vena cava? Rofo 163:523–526PubMedGoogle Scholar
  20. 20.
    Stoneham GW, Burbridge BE, Millward SF (1995) Temporary inferior vena cava filters: In vitro comparison with permanent IVC filters. J Vase Interv Radiol 6:731–736CrossRefGoogle Scholar
  21. 21.
    Linsenmaier U, Rieger J, Rock C, Waydhas C, Pfeifer KJ (1996) Prophylactic use of temporary inferior vena cava filters: Indications, preliminary results. Radiology 201:284Google Scholar
  22. 22.
    Linsenmaier U, Rieger J, Rock C, Waydhas C, Mangel E, Rock C, Trautwein K, Pfeifer KJ (1995) Preliminary experience with temporary inferior vena cava filters: Indications, management and complications. Radiology 197:213Google Scholar
  23. 23.
    Bolz KD, Fjermeros G, Wideroe TE, Hatlinghus S (1995) Catheter malfunction and thrombus formation on double-lumen hemodialysis catheters: An intravascular ultrasonographic study. Am J Kidney Dis 25:597–602PubMedCrossRefGoogle Scholar
  24. 24.
    Prandoni P, Polistena P, Bernardi E, Cogo A, Casara D, Verlato F, Angelini F, Simioni P, Signorini GP, Benedetti L, Girolami A (1997) Upper-extremity deep vein thrombosis: Risk factors, diagnosis, and complications. Arch Intern Med 157:57–62PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1998

Authors and Affiliations

  • Ulrich Linsenmaier
    • 1
  • Johannes Rieger
    • 1
  • Franz Schenk
    • 1
  • Clemens Rock
    • 1
  • Eugen Mangel
    • 1
  • Klaus Jürgen Pfeifer
    • 1
  1. 1.Department of Radiology, Klinikum InnenstadtLudwig-Maximilians-Universität MünchenMunichGermany

Personalised recommendations