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Caval filters in intensive care: a retrospective study
F Ferraro1, T L Di Gennaro1, A Torino1
1Department of Anesthesiological, Surgical and Emergency Sciences, Second University of Naples, Naples, Italy.
Drug Design, Development and Therapy
|November 15, 2014
Summary
A caval vein filter (CVF) monitoring protocol effectively reduces pulmonary embolism (PE) mortality and morbidity. This study highlights temporary CVFs as a safe prophylactic option for ICU patients with transient thromboembolic risk.
Area of Science:
- Vascular Surgery
- Critical Care Medicine
- Interventional Radiology
Background:
- Pulmonary embolism (PE) mortality reduction with caval vein filters (CVFs) is challenged by increased morbidity.
- CVF implantation presents prophylactic and therapeutic complexities.
- Strict peri-implant monitoring protocols are crucial for safe and effective CVF use.
Purpose of the Study:
- To assess the efficacy of a caval vein filter (CVF) peri-implant monitoring protocol.
- To determine the protocol's impact on reducing pulmonary embolism (PE) mortality.
- To evaluate the reduction of CVF-related morbidity.
Main Methods:
- Retrospective analysis of 62 Intensive Care Unit (ICU) patients undergoing CVF implantation (definitive, temporary, or optional).
- Implementation of a peri-implant monitoring protocol including phlebocavography, echo-Doppler, and coagulation tests.
Main Results:
- No thromboembolic recurrences were observed.
- Complications included endothelial adhesion (18%), residual clot (5%), filter migration (6%), microbial colonization (1%), caval thrombosis (1%), and pneumothorax (1%).
- Deep-vein thrombosis (DVT) occurred in 8% of patients, primarily with temporary/optional filters; definitive CVFs (32% of cases) were not associated with DVT.
Conclusions:
- CVF implantation significantly reduces iatrogenic PE without increasing mortality.
- Temporary CVFs are a suitable first-line option for ICU patients with transient thromboembolic risk.
- Careful peri-implant monitoring enhances CVF safety and efficacy as a prophylactic measure.
