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[Vena cava filter -- is there an indication for implantation?].
T Bürger1, Z Halloul, J Tautenhahn
1Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Medizinische Fakultät, Otto-von-Guericke-Universität, Magdeburg.
Zentralblatt Fur Chirurgie
|June 21, 2005
Summary
Vena cava filters are controversial. While safe for selected patients with pulmonary embolism and contraindications to anticoagulation, evidence is limited, necessitating further research before wider use.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiology
Background:
- Vena cava filter implantation indications are debated.
- Limited evidence exists regarding their efficacy and safety.
Purpose of the Study:
- To critically analyze the indications, outcomes, and complications of vena cava filter placement.
- To provide evidence-based recommendations for filter use.
Main Methods:
- Retrospective analysis of 29 vena cava filter (24 temporary, 5 permanent) implantations between 1994-2003.
- Filters indicated for pulmonary embolism with anticoagulation contraindications, recurrent pulmonary embolism on anticoagulation, and prophylactic use.
Main Results:
- No deaths or recurrent pulmonary embolisms occurred post-filter insertion.
- Complications included one inferior vena cava thrombosis per group, thrombi in one-third of removed filters, two local infections, and one filter strut fracture with dislocation.
- Temporary filters were in place for an average of 17 days.
Conclusions:
- Vena cava filters can be safely used in selected patients.
- Further investigation is required due to limited evidence.
- Restrict filter use to patients with deep venous thrombosis and pulmonary embolism unresponsive to anticoagulation or with contraindications, and in highly selected prophylactic cases.