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Related Experiment Videos

Complications following caval interruption

H W Kniemeyer1, W Sandmann, D Bach

  • 1Clinic of Vascular Surgery and Kidney Transplantation, University of Düsseldorf, Germany.

European Journal of Vascular Surgery
|September 1, 1994
PubMed
Summary
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Caval interruption filters prevent pulmonary embolism (PE) but carry risks. Strict criteria are essential for use in high-risk patients to avoid complications and justify their benefits.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiology

Background:

  • Caval interruption devices are commonly used to prevent recurrent pulmonary embolism (PE).
  • Arguments for filter placement include safety, ease of insertion, and convenience.
  • Filters are increasingly placed prophylactically, sometimes without confirmed PE or deep venous thrombosis (DVT).

Purpose of the Study:

  • To evaluate the complications associated with caval interruption.
  • To assess the necessity and justification of current indications for filter placement.
  • To determine the optimal use of caval filters in preventing PE.

Main Methods:

  • Retrospective review of patients treated for complications following caval interruption over an 18-year period.

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  • Analysis of treatment strategies for acute and chronic complications.
  • Comparison of complication rates between filters placed for prophylactic versus therapeutic reasons.

    • Main Results:

    • Eleven patients experienced complications from caval interruption, including acute issues and chronic caval occlusion.
    • Six patients were managed conservatively, while five required surgical intervention (thrombectomy, A.V. fistula).
    • Device removal was performed in four patients; only three permanent filters were placed in the hospital during the study period, with two experiencing complications.

    Conclusions:

    • Caval interruption is effective in selected high-risk patients, particularly for preventing sudden death in massive PE.
    • Stringent criteria for filter placement are crucial to manage acceptable early and late complication rates.
    • Extended or liberal indications for caval interruption are not justified due to potential risks.