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Inferior vena cava filters--percutaneous insertion?
K Y Lau1, K W Sniderman, D J Roebuck
1Department of Diagnostic Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong.
Singapore Medical Journal
|April 28, 2000
Summary
This study compares inferior vena cava (IVC) filter use in Canada and Hong Kong, noting lower deep venous thrombosis (DVT) and pulmonary embolism (PE) incidence in Chinese populations. Angiographers must master percutaneous IVC filter insertion for thromboembolic disease management.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Thromboembolic Disease Management
Background:
- Deep venous thrombosis (DVT) and pulmonary embolism (PE) incidence is significantly lower in Chinese populations compared to Caucasians.
- Inferior vena cava (IVC) filter utilization reflects this disparity, with fewer procedures performed in Hong Kong than in Toronto.
- Despite lower incidence, physicians frequently encounter patients with thromboembolic disease necessitating IVC interruption, often due to anticoagulation failure or contraindications.
Purpose of the Study:
- To highlight the importance of percutaneous IVC filter insertion techniques for angiographers.
- To provide an overview of IVC filter types, insertion methods, and selection guidelines.
- To address the management of thromboembolic disease in patients requiring IVC interruption.
Main Methods:
- Comparative analysis of IVC filter insertion data from Toronto General Hospital and Pamela Youde Nethersole Eastern Hospital.
- Review of indications for IVC filter placement, focusing on anticoagulation contraindications or failure.
- Discussion of percutaneous IVC filter insertion techniques.
Main Results:
- Toronto General Hospital (approx. 700 beds) deployed 36 IVC filters, while Pamela Youde Nethersole Eastern Hospital (approx. 1,250 beds) inserted 8 filters between August 1997 and September 1998.
- The data suggests a lower rate of IVC filter use in Hong Kong compared to Toronto, correlating with population-based DVT/PE incidence.
- The study underscores the need for familiarity with IVC filter procedures despite regional variations in incidence.
Conclusions:
- Angiographers must be proficient in percutaneous IVC filter insertion due to its role in managing thromboembolic events.
- Understanding IVC filter types, insertion techniques, and selection criteria is crucial for effective patient care.
- While incidence varies, the need for IVC interruption in specific clinical scenarios remains a key consideration for vascular specialists.