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Published on: June 4, 2014
[Inferior vena cava interruption: a 17-years experience (1989-2006)]
1Serviço de Angiologia e Cirurgia Vascular do Hospital Pulido Valente, Lisboa, Portugal.
Insights
Venous thromboembolic disease requires anticoagulation, but filters offer an alternative when anticoagulation is risky or ineffective. This review covers vena cava filter history, use, and complications, highlighting their selective application.
Area of Science:
- Vascular Surgery
- Cardiology
- Interventional Radiology
Context:
- Venous thromboembolic disease presents significant morbidity and mortality risks.
- Anticoagulation is standard but has limitations like ineffectiveness or bleeding risks.
- Contraindications to anticoagulation include trauma and major surgery.
Purpose:
- To review the history and evolution of vena cava interruption methods.
- To detail indications, types, and outcomes of various vena cava filters.
- To present a retrospective analysis of 106 definitive vena cava filter insertions.
Summary:
- The study reviews vena cava interruption as an alternative to anticoagulation for pulmonary embolism prevention.
- It analyzes the history, indications, types, and results of commonly used vena cava filters.
- A retrospective analysis of 106 filters inserted between 1989 and 2006 is presented, along with complication analysis.
Impact:
- Vena cava filters are a simple, selective technique for preventing recurrent pulmonary embolism.
- The findings emphasize the need for a multidisciplinary approach in filter selection and management.
- This review provides insights into the long-term outcomes and complications of vena cava filters.
Abstract:
Venous thromboembolic disease is associated with significant morbidity and mortality. Anticoagulation is the gold standard therapy to the venous thromboembolism. However, in a small group of patients, anticoagulation might be ineffective or associated with increased risks of haemorrhage. In addition, anticoagulation might be contraindicated due to the coexistence of other pathologies like trauma, or perioperative period of major surgery. In these circumstances, caval interruption (definitive, temporary), by various methods, has been accepted as an alternative to anticoagulation, to prevent pulmonary embolism. The author reviews the history of the different methods of vena cava interruption, with special attention to the indications, types, and results of the different vena cava filters commonly employed. He presents a retrospective analysis of 106 definitive vein cava filters which were inserted under his guidance from January 1989 through March 2006. Finally, he analyses the most common complications and concludes that it is a simple technique, to be used selectively in recurrent pulmonary thromboembolismo and requiring a multidisciplinary approach.
