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Inferior vena cava interruption with the Hunter-Sessions balloon: eighteen years' experience in 191 cases
J A Hunter1, G A DeLaria, M D Goldin
1Rush Medical College, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
Journal of Vascular Surgery
|October 1, 1989
Summary
The Hunter-Sessions balloon effectively prevented pulmonary embolism in high-risk patients over 18 years. This inferior vena cava interruption device demonstrated no migration or malfunction, improving leg edema post-procedure.
Area of Science:
- Vascular Surgery
- Cardiology
- Pulmonary Medicine
Background:
- Deep venous thrombosis (DVT) and pulmonary embolism (PE) pose significant risks, especially in patients with contraindications or complications from anticoagulation.
- Inferior vena cava (IVC) interruption is a critical intervention for preventing PE in select patient populations.
- The Hunter-Sessions balloon is a device used for IVC interruption.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of the Hunter-Sessions balloon for IVC interruption in patients with DVT and PE.
- To assess the incidence of PE, mortality, and long-term outcomes following IVC interruption with the Hunter-Sessions balloon.
Main Methods:
- A retrospective review of 191 consecutive patients undergoing IVC interruption with the Hunter-Sessions balloon over 18 years.
- Data collection included patient demographics, indications for IVC interruption, procedural details, in-hospital outcomes, and long-term follow-up.
- Diagnostic methods for PE included ventilation-perfusion scanning, angiography, and clinical assessment.
Main Results:
- 165 patients (86%) had a history of PE; 52% were in significant cardiopulmonary distress at the time of procedure.
- No patient experienced PE while in the hospital after Hunter-Sessions balloon insertion; no in-hospital deaths were related to the procedure.
- Long-term follow-up showed no device malfunction or migration, with 75% of patients free of leg edema and no late deaths attributed to PE.
Conclusions:
- The Hunter-Sessions balloon is a safe and effective method for IVC interruption in patients at high risk for PE.
- The device successfully prevented PE in the peri-procedural period and demonstrated favorable long-term outcomes regarding leg edema and device integrity.
- IVC interruption with the Hunter-Sessions balloon offers a viable alternative for patients with contraindications or complications related to anticoagulation therapy.