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Related Experiment Videos

[Experiences with using a potentially temporary vena cava filter in multiple trauma patients].

A Platz1, W Ertel, N Helmy

  • 1Klinik für Unfallchirurgie, Universitätsspital Zürich, Schweiz. andreas.platz@chi.usz.ch

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|July 27, 2001
PubMed
Summary

Temporary vena cava filters are safe and effective for trauma patients with multiple injuries who cannot use anticoagulation. This procedure helps prevent fatal pulmonary emboli in high-risk individuals.

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Area of Science:

  • Vascular Surgery
  • Trauma Surgery
  • Interventional Radiology

Background:

  • Multiple injuries pose a high risk for thromboembolic events, including thrombosis and pulmonary emboli, particularly in patients with pelvic fractures, spinal injuries, or lower extremity fractures.
  • Anticoagulation is often contraindicated in patients with severe head injuries, necessitating alternative prophylactic measures.
  • Experience with temporary vena cava filter (TCF) application in polytrauma patients in Europe is limited.

Purpose of the Study:

  • To evaluate the safety and efficacy of temporary vena cava filters in patients with multiple injuries.
  • To assess the complication rate and effectiveness of TCFs in preventing pulmonary emboli in a high-risk trauma population.

Main Methods:

  • A consecutive series of 24 multiple-injury patients treated with a temporary vena cava filter were retrospectively analyzed.

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  • Filters were inserted via the femoral (20 patients) or jugular (4 patients) vein.
  • Patient data included Injury Severity Score (ISS), specific injuries (pelvic, spinal, head), and indications for filter placement (prophylactic, pre-existing thrombosis, or pulmonary emboli).

    • Main Results:

    • No complications were reported during the insertion procedure.
    • One patient (4.2%) developed caval thrombosis as the sole complication.
    • The study involved patients with a mean ISS of 35.1, including 19 with pelvic injuries and 17 with severe head injuries.

    Conclusions:

    • Temporary vena cava filter insertion is a safe and effective procedure for multiple-injury patients with contraindications to anticoagulation.
    • TCFs serve as a crucial tool in preventing fatal pulmonary emboli in this vulnerable patient group.
    • The findings support the wider application of TCFs in managing thromboembolic risk in polytrauma.