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[Vena cava umbrella filter: complications and treatment]
R Ritter1, M Pillny, K Grabitz
1Klinik für Gefässchirurgie und Nierentransplantation, Heinrich-Heine-Universität Düsseldorf.
Deutsche Medizinische Wochenschrift (1946)
|October 8, 1998
Summary
Vena caval filter removal is safe and effective for preventing pulmonary embolism. Post-removal, anticoagulation is sufficient, making repeat filter implantation unnecessary.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiology
Context:
- Pulmonary embolism (PE) is a significant risk, often stemming from deep vein thrombosis (DVT) and pelvic vein thrombosis.
- Inferior Vena Cava (IVC) filters are increasingly used to prevent PE, but complications can necessitate their removal.
Purpose:
- To assess the safety and efficacy of operative vena caval filter explantation.
- To evaluate the risks associated with filter removal and subsequent pulmonary embolism.
- To determine the long-term patency of large veins after thrombectomy and filter explantation.
Summary:
- This study retrospectively analyzed nine patients who underwent operative removal of IVC filters due to complications.
- All filter explantations were successful, with two nonfatal postoperative complications (pulmonary and cerebral emboli).
- Post-removal, IVCs and pelvic veins remained patent in most patients, with no instances of postoperative PE.
Impact:
- Vena caval filter explantation can be performed with low operative risk.
- Effective anticoagulation can prevent PE, rendering repeat filter implantation unnecessary after removal.
- Filter implantation should be reserved for the strictest indications as a last resort.