Long-term follow-up for superior vena cava filter placement

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Cardiology

Background:

• Short-term effectiveness and safety of superior vena cava (SVC) filters for upper extremity deep venous thrombosis (UEDVT) in patients with anticoagulation contraindications are established.
• Limited long-term follow-up data exist for SVC filter placement, unlike the more extensively studied inferior vena cava filters.
• This study aims to evaluate the long-term outcomes and complications of SVC filter placement.

Purpose of the Study:

• To assess the long-term safety and effectiveness of superior vena cava (SVC) filter placement.
• To identify insertion and long-term complications associated with SVC filters.
• To provide data on the durability and clinical outcomes of SVC filters in patients with UEDVT.

Main Methods:

• Retrospective review of 154 patients who underwent SVC filter placement between January 1994 and August 2005.
• Data collected on insertion complications (pneumothorax, hemorrhage, misplacement) and long-term complications (pulmonary embolism, migration, caval occlusion).
• Follow-up included chest radiographs, patient charts, clinic visits, telephone contacts, and death records.

Main Results:

• All 154 SVC filters (TrapEase and Greenfield) were successfully deployed.
• Low incidence of complications: three cases of pericardial tamponade (1.9%) and one misplaced filter.
• No cases of symptomatic pulmonary embolism, caval occlusion, pneumothorax, or filter migration were observed; 74% mortality due to underlying conditions.

Conclusions:

• Superior vena cava (SVC) filter placement demonstrates a low incidence of complications during long-term follow-up.
• The findings reaffirm the safety and effectiveness of SVC filters for indicated patients.
• SVC perforation in young males remains a notable concern requiring further investigation.