Clinical experience with vena caval filters in high-risk cancer patients

Our experience with the placement of intracaval filter devices in patients with malignancies, is reviewed. Seventy patients had either a Mobin Uddin or Greenfield Umbrella Filter placed since 1971. The indications for caval interruption in our series included contraindications to anticoagulant therapy, bleeding with anticoagulant therapy, and recurrent pulmonary embolism with anticoagulant therapy. Of the 70 patients, 47 had a diagnosis of deep vein thrombosis, 15 had the diagnosis of pulmonary embolus, and eight had the diagnosis of both deep vein thrombosis and pulmonary embolus. The types of malignancies that were present in our patients included breast carcinoma, gynecologic tumors, colon tumors, pancreatic carcinoma, and hematologic malignancies. We report no operative mortality and a low operative morbidity of 7% utilizing this method of caval interruption. The late morbidity of stasis sequelae following caval interruption was present in 14% of the patients. Based on a favorable experience with this method of vena cava interruption in high-risk patients with advanced malignancies, the authors suggest a more liberal indication for caval interruption in this group of patients.