Abstract
Purpose
Although prophylactic anticoagulants reduce the risk of acute pulmonary embolism (PE), inferior vena cava filters (IVCF) remain elusive in prophylactic use. This study investigated whether IVCF in addition to anticoagulants augment the prophylactic effect on acute PE in the highest-risk patients.
Methods
This study included patients with existing venous thromboembolism (VTE) or a history of previous PE, who underwent subsequent surgery for the underlying disease. The hospital records of the patients were reviewed.
Results
Forty-nine consecutive patients treated from October 2001 to June 2007 were assessed, including 13 men and 36 women with a mean age of 58.1 years. The underlying diseases that required surgery included malignancy in 23, orthopedic disorder in 14, and others in 12. All patients received anticoagulants, with perioperative IVCF in 31 patients or without in 18. Neither group had any fatal complications. The no-filter group had no cases of recurrent PE, whereas the filter group had one case of recurrent PE just after placement of the filter. Moreover, 5 cases in the filter group had filter-related complications.
Conclusion
This study suggested that the addition of IVCF to anticoagulants does not provide a substantial risk reduction for perioperative patients with VTE prior to surgery.
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References
Kearon C, Hirsh J. Management of anticoagulation before and after elective surgery. N Engl J Med 1997;336:1506–1511.
Low-molecular-weight heparin in the treatment of patients with venous thromboembolism. The Columbus Investigators. N Engl J Med 1997;337:657–662.
Ishida K, Masuda M. Review of acute pulmonary embolism in a general hospital. Surg Today 2007;37:740–744.
Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126:338S–400S.
Whitehill TA. Current vena cava filter devices and results. Semin Vasc Surg 2000;13:204–212.
Athanasoulis CA, Kaufman JA, Halpern EF, Waltman AC, Geller SC, Fan CM. Inferior vena caval filters: review of a 26-year single-center clinical experience. Radiology 2000;216:54–66.
Girard P, Stern JB, Parent F. Medical literature and vena cava filters: so far so weak. Chest 2002;122:963–967.
Stein PD, Kayali F, Olson RE. Twenty-one-year trends in the use of inferior vena cava filters. Arch Intern Med 2004;164:1541–1545.
Decousus H, Leizorovicz A, Parent F, Page Y, Tardy B, Girard P, et al. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prevention du Risque d’Embolie Pulmonaire par Interruption Cave Study Group. N Engl J Med 1998;338:409–415.
Rosenthal D, Wellons ED, Hancock SM, Burkett AB. Retrievability of the Gunther Tulip vena cava filter after dwell times longer than 180 days in patients with multiple trauma. J Endovasc Ther 2007;14:406–410.
Looby S, Given MF, Geoghegan T, McErlean A, Lee MJ. Gunther Tulip retrievable inferior vena caval filters: indications, efficacy, retrieval, and complications. Cardiovasc Intervent Radiol 2007;30:59–65.
Miyahara T, Miyata T, Shigematsu K, Deguchi J, Kimura H, Ishii S, Nagawa H. Clinical outcome and complications of temporary inferior vena cava filter placement. J Vasc Surg 2006;44:620–624.
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Deguchi, J., Nagayoshi, M., Miyahara, T. et al. Do inferior vena cava filters reduce the risk of acute pulmonary embolism in preoperative patients with venous thromboembolism?. Surg Today 40, 533–537 (2010). https://doi.org/10.1007/s00595-008-4085-z
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DOI: https://doi.org/10.1007/s00595-008-4085-z