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Inferior vena caval filter use in U.S. trauma centers: a practitioner survey
T E Quirke1, P C Ritota, K G Swan
1Department of Surgery, University of Medicine and Dentistry of New Jersey, Newark, USA.
The Journal of Trauma
|August 1, 1997
Summary
Trauma surgeons have differing opinions on when to use inferior vena cava (IVC) filters, with consensus on absolute indications like pulmonary embolism but lower use than expected. Removability could increase prophylactic filter use.
Area of Science:
- Trauma Surgery
- Interventional Radiology
- Vascular Surgery
Background:
- Inferior vena cava (IVC) filters are used to prevent pulmonary embolism.
- Consensus on indications for IVC filter placement among trauma surgeons is not well-established.
Purpose of the Study:
- To determine the consensus among U.S. trauma surgeons regarding indications for IVC filter placement.
- To explore factors influencing IVC filter use and perceived contraindications.
Main Methods:
- A questionnaire was mailed to 620 U.S. trauma surgeons.
- Data analysis of 210 (34%) responses regarding filter placement indications, contraindications, complications, and provider demographics.
Main Results:
- Consensus exists for absolute indications (e.g., pulmonary embolism, contraindications to anticoagulation).
- Relative indications include deep venous thrombosis, spinal cord injury, and fractures.
- Low monthly filter use (0-1 filters in 60% of centers) despite low reported complications.
- Removability significantly increases consideration for prophylactic placement in specific cases.
- Radiologists perform most filter insertions (81%).
Conclusions:
- While indications are defined, IVC filter use in trauma centers is lower than anticipated.
- The permanent nature of filters may limit prophylactic use.
- Provider preference and training (radiologists vs. surgeons) influence placement rates.