[Vena cava filter--prevention of pulmonary embolism. Report of clinical experiences]

Between 1982 and 1997 inferior vena cava filters were implanted in 182 patients. Indications were recurrent pulmonary embolism, massive embolism and prophylactic use prior to planned high-risk-operations upon patients with thromboembolic complications in shorter history. Kimray-Greenfield, Cardial and Vascor-systems were implanted. Mortality was 0, neither relevant bleedings, nor infections occurred. Vena-cava-filters prevented from re-embolism in 98%. During hospitalisation 3 cases of re-embolism (1.6%) were noticed due to incorrect filter-placement. One patient died (< 1%). Follow-up-examinations were performed in 74 cases 6 to 24 months after implantation. We discovered 8 cases (11%) of filter-migration, 3 cases (4%) of filter-kinking, one case of filter-perforation and one case of filter-shrut-fracture. All these patients remained without clinical sequelae. Cava-thrombosis was found in 2 patients 6 to 24 months after filter-insertion (2.7%). There was no sign of re-embolism in our longterm follow-up. In our opinion the vena cava filter is an effective and safe method to prevent pulmonary re-embolism. Handling is quite easy and filter complications are low. In some elected cases prophylactic use of vena cava filters in high-risk-patients may be indicated.