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LGM (Vena Tech) vena caval filter: experience at a single institution
S F Millward1, R A Peterson, D Moher
1Department of Radiological Sciences, Ottawa Civic Hospital, Ontario, Canada.
Insights
This study on LG-Medical (LGM) vena cava filters found a higher rate of inferior vena cava (IVC) occlusion than previously reported, indicating it may be a serious complication. Filter placement via femoral veins showed fewer complications than jugular vein insertion.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Medical Device Evaluation
Background:
- Inferior Vena Cava (IVC) filters are used to prevent pulmonary embolism.
- Assessing the safety and efficacy of specific IVC filter models is crucial for patient care.
- LG-Medical (LGM) Vena Tech filters represent a specific device for clinical consideration.
Purpose of the Study:
- To evaluate the clinical experience with the placement and follow-up of LG-Medical (LGM) vena cava filters.
- To assess the complication rates associated with LGM filter placement using different venous access routes.
- To determine the incidence and significance of inferior vena cava (IVC) occlusion following LGM filter implantation.
Main Methods:
- A cohort of 63 patients received LGM vena cava filters.
- Follow-up included duplex sonography, abdominal radiography, autopsy, and clinical assessment.
- Complications such as filter malposition, failure to open, thrombosis, and IVC occlusion were recorded.
Main Results:
- Major placement complications occurred in 3 patients, exclusively with right internal jugular vein access.
- Pulmonary embolism recurred in 6% of patients, with one fatality.
- Inferior vena cava (IVC) occlusion occurred in 24% of patients, symptomatic in 19%, and was associated with recurrent PE in two cases.
Conclusions:
- The incidence of IVC occlusion with LGM filters appears higher than previously reported.
- IVC occlusion is a potentially serious complication that warrants careful monitoring.
- Femoral vein access for LGM filter placement is associated with fewer immediate complications compared to jugular vein access.
Purpose:
The authors describe their experience with LG-Medical (LGM [Vena Tech]) filter placement and follow-up.
Patients And Methods:
LGM vena cava filters were placed in 63 patients. Follow-up was obtained by means of duplex sonography of the introduction vein and inferior vena cava (IVC) and abdominal radiography in 50 patients, and by means of autopsy in an additional four patients. In eight, only clinical follow-up was obtained and one patient was lost to follow-up.
Results:
Major complications of placement occurred in three patients, all when the right internal jugular vein was used for introduction: In one patient a filter was inadvertently placed in the right renal vein and in two the filter failed to open fully. No serious complications of placement occurred when either the right or left common femoral veins were used. Pulmonary embolism (PE) recurred in four patients (6%) and was fatal in one. Septicemia from an infected filter was the probable cause of death in another patient. Introduction vein thrombosis occurred in five patients (8%) and was symptomatic in two (3%). Occlusion of the IVC occurred in 15 patients (24% of the total patient group, but 28% of those with objective follow-up) and was symptomatic in 12 (19%). Two patients with IVC occlusion had recurrent PE.
Conclusion:
These data suggest that the rate of IVC occlusion is higher than most previous reports have suggested and that IVC occlusion may be a potentially serious complication.