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[Comparison of Gunther, Filcard and LGM definitive caval filters. Our experience]
S Mosca1, A Maselli, P Pozzilli
1Istituto di Radiologia, Università degli Studi, Perugia.
Insights
This study evaluated 30 caval filter placements over three years, comparing Gunther, Filcard, and LGM filters. While effective in preventing pulmonary embolism, no single filter emerged as ideal, necessitating further research.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- Inferior Vena Cava (IVC) filters are crucial for preventing pulmonary embolism in high-risk patients.
- Various IVC filter designs exist, each with potential benefits and drawbacks.
Purpose of the Study:
- To report clinical experience with 30 IVC filter placements.
- To compare the performance and complication rates of different IVC filter types (Gunther, Filcard, LGM).
- To assess the efficacy and safety of IVC filters in preventing pulmonary embolism.
Main Methods:
- Retrospective review of 30 IVC filter placements over three years.
- Categorization of filters by type (Gunther, Filcard DF-01, Filcard DF-04, LGM) and insertion site (right common femoral vein, right internal jugular vein).
- Analysis of early and late complications, including mispositioning, incomplete opening, tilting, and mortality, with radiologic follow-up (conventional radiology, US, cavography, MR, CT).
Main Results:
- A total of 30 IVC filters were placed: 8 Gunther, 16 Filcard (4 DF-01, 12 DF-04), and 6 LGM.
- Filters were inserted via the right common femoral vein (60%) or right internal jugular vein (40%).
- Early complications included 1 mispositioning (LGM), 2 incomplete openings (Filcard DF-01), 3 significant tiltings (Filcard DF-04), and 1 mortality (Gunther). No late complications were observed during radiologic follow-up.
Conclusions:
- All evaluated IVC filters demonstrated effectiveness in preventing pulmonary embolism.
- Each filter type presented unique advantages and disadvantages.
- Further research is required to identify the optimal "ideal" IVC filter for clinical practice.
Abstract:
The authors report their experience with 30 caval filters placed throughout 3 years, and compare it with the data from the literature. In 8 patients (26.5%) Gunther filters were used, in 16 cases (53.5%) Filcard filters (4 DF-01 and 12 DF-04) and finally the last 6 patients (20%) were treated with LGM filters. In 18 cases (60%) the filters were positioned through right common femoral vein, whereas in the remaining 12 patients (40%) they were placed through the right internal jugular vein. Early complications were 1 mispositioning (3.3%) with a LGM filter, 2 incomplete opening (6.6%) of Filcard DF-01 filters, 3 significant tiltings (10%) with Filcard DF-04 filters. One patient (3.3%) died one week after the placement of a Gunther filter. The radiologic follow-up, which included controls with conventional radiology, US, cavography, MR and CT revealed no later complications. All the filters exhibited both advantages and disadvantages. Although all the filters commonly in use are effective to prevent pulmonary embolism, further experience is necessary to find out the "ideal" filter.