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Long-term safety and effectiveness of inferior vena cava filters in patients with stroke

Bhanusupriya Somarouthu1, Kalpana Yeddula, Stephan Wicky

  • 1Department of Imaging, Massachusetts General Hospital, Boston, MA, USA.

Journal of Neurointerventional Surgery
|October 13, 2011
PubMed

Insights

Inferior vena cava (IVC) filters are safe and effective for stroke patients, preventing life-threatening pulmonary embolism (PE). This study confirms their acceptable safety profile in this vulnerable population.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Medical Device Safety

Background:

  • Stroke patients are at high risk for venous thromboembolism (VTE).
  • Inferior vena cava (IVC) filters are used to prevent pulmonary embolism (PE) in patients with contraindications to anticoagulation.
  • Long-term safety and effectiveness data for IVC filters in stroke patients are limited.

Purpose of the Study:

  • To evaluate the long-term safety and clinical effectiveness of IVC filters in patients who have experienced a stroke.
  • To assess complications associated with IVC filter placement and use in this patient cohort.

Main Methods:

  • Retrospective study of 371 stroke patients treated with IVC filters between 2002 and 2009.
  • Data collected included demographics, stroke type, indications for filter, procedural complications, post-filter PE and deep vein thrombosis (DVT), caval occlusion, and filter-related complications.
  • Safety assessed by complication rates; effectiveness by occurrence of fatal and non-fatal PE.

Main Results:

  • 180 patients (49%) died during follow-up, primarily from underlying disease.
  • Symptomatic post-filter PE and DVT occurred in 15% and 16% of patients, respectively.
  • Three deaths (0.8%) were attributed to post-filter PE; symptomatic caval occlusion occurred in 1.3%.

Conclusions:

  • IVC filters demonstrate an acceptable safety profile in stroke patients.
  • The filters were effective in preventing life-threatening pulmonary embolism in this cohort.
  • IVC filter use should be considered in stroke patients at high risk for PE.
Abstract

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