[Inferior vena cava interruption: a 17-years experience (1989-2006)]

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.