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[Long-term results after caval filter implantation]
J Schweizer1, H J Florek, R Kaulen
12. Medizinische Klinik des Städtischen Klinikums Dresden-Friedrichstadt, Dresden.
Insights
Filter implantation for embolism prevention shows positive long-term results. Post-operative care with anticoagulants and compression maintains vein patency, reducing embolism risk.
Area of Science:
- Vascular surgery
- Interventional radiology
- Medical device technology
Background:
- Inferior vena cava (IVC) filters are used to prevent pulmonary embolism.
- Long-term outcomes and optimal management of IVC filter patients require further clarification.
Purpose of the Study:
- To evaluate the long-term results of IVC filter implantation.
- To determine the best post-operative management strategies for patients with IVC filters.
Main Methods:
- Prospective observation of 92 patients with implanted IVC filters for up to 6 years.
- Follow-up included clinical assessment, radiography, CT venography, and duplex sonography of the vena cava and lower extremities.
Main Results:
- Two early Günther filter dislocations occurred within 3 months.
- 85% of patients on anticoagulants and compression had patent pelvic veins, despite initial thrombi.
- The IVC remained patent in the filter area in 72 cases.
Conclusions:
- IVC filter implantation can achieve positive long-term outcomes.
- Post-operative anticoagulation and compression therapy are effective in maintaining venous patency and preventing embolism.
- Careful patient selection and management are crucial for successful IVC filter use.
Abstract:
In order to help clarify the long-term results of filter implantation and how best to manage the post-operative care, 92 patients with implanted filters were observed for up to 6 years. The follow-up examinations included detailed interrogation, a clinical investigation, plain abdominal radiography in two planes, contrast-enhanced computed tomography of the vena cava and colour-coded duplex sonography of the vena cava and the veins of the pelvic and legs. In the early phase of the study, two patients who received Günther filters in 1988 experienced dislocation of the filter after 3 months. In the later phase, 85% of those treated with oral anti-coagulants and compression showed patent pelvic veins in areas where, at the time of filter implantation, there had been thrombi with the potential to cause embolism. In 72 cases, the inferior v.cava proved to be patent in the area of the filter.