Temporary vena caval filtration. Preliminary clinical experience with removable vena caval filters

Removable vena caval devices look attractive in order to prevent pulmonary embolism (PE) in high risk patients when anticoagulant therapy has to be discontinued for periods shorter than 14 days. We describe our preliminary experience about 10 consecutive patients. All patients were anticoagulated for recent venous thromboembolism and the indication of vena caval filtration was mainly a short-term contraindication to anticoagulation due to surgery (8 cases) or delivery (1 case). Gunther Tulip retrievable vena caval device was used. No clinical manifestation of PE occurred during the filtration period. No thrombosis was detected at the insertion site, nor was any filter thrombosis found at the time of retrieval. Eight out of ten filters were easily retrieved through internal jugular vein. In one patient, filter could not be removed due to device tilting; in two patients, permanent filtration was secondarily requested. These results suggest that temporary vena caval filtration is efficient and safe for preventing pulmonary embolism during a short-term discontinuation of anticoagulant therapy in high risk patients.