Annals of Vascular Surgery

, Volume 5, Issue 2, pp 186–189 | Cite as

Thromboembolic complications in patients with advanced cancer: Anticoagulation versus greenfield filter placement

  • Keith D. Calligaro
  • William S. Bergen
  • Michael J. Haut
  • Ronald P. Savarese
  • Dominic A. DeLaurentis
Papers from the Peripheral Vascular Surgery 1990 Meeting
  • 15 Downloads

Abstract

Thirty patients with Stage III/IV cancer and thromboembolic complications between 1987–89 were reviewed. Twelve patients had a deep venous thrombosis proximal to the calf diagnosed by duplex scanning or contrast venography, 15 patients had a pulmonary embolism diagnosed by a high-probability pulmonary ventilation/perfusion scan or arteriogram, and three patients had both deep vein thrombosis and pulmonary embolism. Patients were treated primarily with anticoagulation (Group A =20 patients) or a Greenfield filter (Group B=10 patients). Seventy-five percent (15/20) of the Group A patients developed 19 bleeding or thrombosis-related complications: major bleeding (7), recurrent deep venous thrombosis/pulmonary embolism (4), inability to attain consistent therapeutic anticoagulation levels (3), heparininduced thrombocytopenia (3), or progression of deep vein thrombosis (2). A Greenfield filter was eventually placed in 10 (50%) of the Group A patients without complications. Thirty percent (3/10) of the Group B patients developed progression of deep vein thrombosis that required anticoagulation. One other Group B patient died due to a guidewire-induced arrhythmia. Although patients with advanced cancers and venous thromboembolic disease have a high complication rate with either treatment, initial treatment with a Greenfield filter appears more definitive. Anticoagulation should be reserved for patients with progressive, symptomatic deep vein thromboses after placement of a filter.

Key words

Deep venous thrombosis cancer anticoagulation Greenfield filter pulmonary embolism 

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Copyright information

© Annals of Vascular Surgery Inc. 1991

Authors and Affiliations

  • Keith D. Calligaro
    • 1
  • William S. Bergen
    • 1
  • Michael J. Haut
    • 1
  • Ronald P. Savarese
    • 1
  • Dominic A. DeLaurentis
    • 1
  1. 1.Section of Vascular Surgery, and Departments of Medicine and PathologyPennsylvania Hospital/University of Pennsylvania School of MedicinePhiladelphia

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