Aims and objectives
In the last decades,
the use of inferior vena cava filters (IVCF) has constantly increased [1],
mainly because of the introduction and increasing application of retrievable devices [2].
Even if anticoagulation (Ac) is the first-line therapy for venous thromboembolism (VTE),
in some patients this treatment is contraindicated and IVCF represents a valid alternative to prevent life-threatening pulmonary embolism (PE).
A constant evolution of filters’ design and material has led to an increase in the use of such devices.
Nevertheless,
there is still uncertainty about the...
Methods and materials
The examined population consisted of patients treated with a permanent or retrievable IVCF from November 1999 to January 2017 in the hospitals of Padua.
An electronic interventional radiology database,
based on medical records,
radiological archives,
clinical and follow-up data was established; the relationship among the investigated variables was then statistically evaluated.
Results
An overall amount of 638 patients was included.
Four hundred forty-nine patients were treated with permanent IVCFs and 189 with retrievable ones.
The number of filters placed over the years (Figure 1) showed a steady increase (p<0.0001).
The number of retrievable vena cava filters,
rather than the one of permanent,
significantly increased (p<0.0001).
During the interval 2010-2014 the application of these two types of device was balanced,
whereas just recently the retrievable filters became more prevalent.
Considering all risk factors and co-morbidities associated with VTE,...
Conclusion
Therapy for recurrent VTE with inferior vena cava filters should be carefully evaluated and tailored on each patient considering factors such as life expectation,
clinical indications for a permanent or a retrievable cava filter,
contraindications and risks of anticoagulant therapy.
A broad and deep knowledge of the most recent indications and guidelines about this topic is mandatory for any physician dealing with this matter.
Positioning and retrieval procedures should be performed only in selected tertiary centers by experienced radiologists aiming thus to reduce the complication...
Personal information
R.
Motta,
Department of Medicine DIMED,
Radiology,
University of Padua,
Via Giustiniani 2,
35128 Padova,
Italy.
Phone: +390498212357; fax +390498211878
E-mail:
[email protected]
References
1.
Duszak R,
Jr,
Parker L,
Levin DC,
Rao VM.
Placement and removal of inferior vena cava filters: national trends in the medicare population.
J Am Coll Radiol.
2011;8:483–489.
doi: 10.1016/j.jacr.2010.12.021.
2.
Friedell ML,
Nelson PR,
Cheatham ML.
Vena cava filter practices of a regional vascular surgery society.
Ann Vasc Surg.
2012 Jul;26(5):630-5.
doi: 10.1016/j.avsg.2011.11.033.
3.PREPIC Study Group.
Decousus H,
Buchmuller-Cordier A,
Carbonnier B,
Girard P,
Lamer C,
Laporte S,
Leizorovicz A,
Mismietti P,
Parent F,
Quenet S,
Rivron-Guillot K,
Tardy B.
Eight-year follow-up of...