scholarly journals Retrospective analysis of outcomes following inferior vena cava (IVC) filter placement in a managed care population

2017 ◽  
Vol 44 (2) ◽  
pp. 179-189 ◽  
Author(s):  
Damian Everhart ◽  
Jamieson Vaccaro ◽  
Karen Worley ◽  
Teresa L. Rogstad ◽  
Mitchel Seleznick
Keyword(s):  
Managed Care ◽  
Inferior Vena Cava ◽  
Retrospective Analysis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Ivc Filter ◽  
Filter Placement

Perforation of inferior vena cava during filter placement

VASA ◽  
2011 ◽  
Vol 40 (2) ◽  
pp. 157-162 ◽  
Author(s):  
Piecuch ◽  
Wiewiora ◽  
Nowowiejska-Wiewiora ◽  
Szkodzinski ◽  
Polonski
Keyword(s):  
Pulmonary Embolism ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Retroperitoneal Hematoma ◽  
Ivc Filter ◽  
Filter Placement ◽  
Therapeutic Method

The placement of an inferior vena cava (IVC) filter is a therapeutic method for selected patients with deep venous thrombosis and pulmonary embolism. However, insertion and placement of the filter may be associated with certain complications. For instance, retroperitoneal hematoma resulting from perforation of the wall by the filter is such a very rare but serious complication. We report the case of a 64-year-old woman with perforation of the IVC wall and consecutive hematoma caused by the filter who was treated surgically.

Duplication of the Inferior Vena Cava in a Patient Presenting for IVC Filter Placement

2010 ◽  
Vol 11 (2) ◽  
pp. 162-164 ◽  
Author(s):  
Danny Cheng ◽  
Steven M. Zangan
Keyword(s):  
Inferior Vena Cava ◽  
Protein C ◽  
Inferior Vena ◽  
Vena Cava ◽  
Factor V Leiden ◽  
Clinical Implications ◽  
Factor V ◽  
Ivc Filter ◽  
Protein C Deficiency ◽  
Filter Placement

Given the complex embryogenesis of the inferior vena cava (IVC), anatomic variations are commonly encountered. Duplication of the IVC occurs in up to 2.8% of the population. Though asymptomatic, a duplicated IVC has important clinical implications when attempting caval filtration. We present the case of a 45- year-old male with factor V leiden and protein C deficiency, who required cessation of warfarin anticoagulation in preparation for cervical laminectomy. The patient had a duplicated IVC and required placement of a caval filter in each IVC.

Supplemental Use of Inferior Vena Cava Filters: A Review of An Institutional Experience.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1279-1279
Author(s):  
Parminder Singh ◽  
Robert G. Lerner ◽  
Tarun Chugh ◽  
Hoang Lai ◽  
Wilbert S Aronov
Keyword(s):  
Pulmonary Embolism ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Thromboembolic Disease ◽  
Ivc Filter ◽  
Filter Placement ◽  
Ivc Thrombosis ◽  
Venous Thromboembolic ◽  
Post Filter

Abstract Introduction: Increasing use of inferior vena cava (IVC) filters in recent years as a preventative measure against pulmonary embolism (PE) has raised concern for usage outside of accepted guidelines. Based on the American College of Chest Physicians 2004 guidelines for the initial treatment of deep vein thrombosis (DVT) and PE, and the Eastern Association for the Surgery of Trauma 2002 guidelines for prophylaxis of PE, placement of an IVC filter is indicated in patients who either have, or are at high risk for thromboembolism, but have a contraindication for anticoagulation, a complication of anticoagulant treatment, or recurrent thromboembolism despite adequate anticoagulation. The purpose of our study is to identify patients who meet the guidelines for IVC filter placement and to compare clinical outcomes with those who did not meet the guidelines. Methods: Charts of 558 patients who received IVC filter placement were reviewed from Jan 1, 2004 to Dec 31, 2007. Patients were divided into two groups called within-guidelines or supplemental. The within-guidelines group included patients that met the criteria described above. The supplemental indication group included patients who did not have a contraindication or failure of anticoagulation. Patient characteristics and clinical outcomes between the two groups were compared and analyzed. Results: The within-guidelines group had 362 patients and the supplemental group had 196 patients. While there were more males in the within-guidelines group, age, race, length of stay, and in-hospital mortality were comparable between the two groups. Clinical follow-up in patients with a supplemental indication showed 1 (0.5%) case of post-filter PE, 2 (1%) cases of IVC thrombosis, 7 (3.6%) cases of DVT. Patients who were in the within-guidelines indication group had 4 (1.1%) cases of post-filter PE, 13 (3.6%) cases of IVC thrombosis, and 34 (9.4%) cases of DVT. All patients who developed post-filter PE had a prior DVT at the time of filter placement, and the risk of developing post-filter IVC thrombosis and PE is higher in patients with prior thromboembolic disease. Conversely, patients who did not have a VTE event before filter placement were at a significantly lower risk of developing IVC thrombosis and PE. Conclusion: Anticoagulation should be initiated at the earliest possible time in patients treated with an IVC filter to prevent subsequent venous thromboembolic disease. Our data does not support the use of IVC filter in patients who can tolerate anticoagulation and have no prior venous thromboembolic event due to the low risk of developing pulmonary embolism

scholarly journals Chronic Inferior Vena Cava Filter Thrombosis: Endovascular Treatment and One-Year Follow-Up with Intravascular Ultrasonography

2020 ◽  
Vol 47 (2) ◽  
pp. 140-143
Author(s):  
Andrés Mesa ◽  
Eliana Milazzo ◽  
Oscar Rivera ◽  
Tabata Hernández ◽  
Gilberto Umanzor
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Neointimal Hyperplasia ◽  
Vena Cava ◽  
Ivc Filter ◽  
Intravascular Ultrasonography ◽  
Filter Placement ◽  
Vein Thrombosis ◽  
History Of ◽  
One Year

Inferior vena cava (IVC) filter thrombosis can be fatal when it is not detected and treated. Its management can be challenging, because little evidence supports specific treatments. We present the case of a 72-year-old man with a history of deep vein thrombosis in whom IVC filter thrombosis developed 7 years after filter placement. Recanalization with oral anticoagulation had failed. Using intravascular ultrasonography, we performed pharmacomechanical thrombolysis, deploying 2 stents simultaneously through the IVC filter and then 2 more into the iliac veins, with excellent results. One year later, the patient's veins and IVC filter were patent, his symptoms were greatly improved, and only nonobstructive neointimal hyperplasia was seen. This case highlights the usefulness of balloon venoplasty and double-barrel stent placement in restoring blood flow through an occluded IVC, and the value of intravascular ultrasonography during and after such procedures.

Placement of Simultaneous Inferior Vena Cava Filter During Emergent Open Pulmonary Thromboembolectomy

2021 ◽  
Vol 39 ◽  
Author(s):  
Paul Lajos ◽  
◽  
Ronald Bangiyev ◽  
Scott Safir ◽  
Alan Weinberg ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cardiopulmonary Bypass ◽  
Length Of Stay ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Ivc Filter ◽  
Filter Placement ◽  
Risk Of Death

Background: This study retrospectively reviewed results of simultaneous (SIM) inferior vena cava (IVC) filter and separate (SEP) IVC filter placement with open pulmonary thromboembolectomy (PTE) in pulmonary embolism and its clinical outcomes. Materials and Methods: From November 2006 to May 2014, 23 patients (14 females and 9 males; median age 58 years; range, 21–88 years) underwent emergent PTE for submassive (12) or massive (11) pulmonary embolism (PE). All had a preoperative computed tomography (CT) scan and echocardiography consistent with right ventricular (RV) strain. Mean cardiopulmonary bypass times and temperatures; chest tube outputs; length of stay; perioperative complications; and survival were compared between groups. Results: There were 13 patients in the SIM group and 10 in the SEP group. PE consisted of 14 acute (60.9%) and nine acute on chronic (39.1%). There were seven deaths (30.4%). Median follow up was 44 days (range, 2–2204 days). Follow up was 81% complete in surviving patients. Actuarial survival at one and three years was 83% for the SIM group and 43% for the SEP group, respectively. There were no differences in cardiopulmonary bypass (CPB) times and temperatures, chest tube outputs, or length of stay between groups. Using multivariable logistic regression, we found SIM was associated with increased survival (p=0.09). Further analysis showed patients >55 years in the SEP group were at significantly higher risk of death (hazard ratio [HR]=7.1:1; 95% confidence interval [CI]: 1.55, 32.5, p=0.011). Conclusion: IVC filter placement can be performed simultaneously and safely at PTE. Age >55 years and PTE with IVC filter placed separately were at significantly higher risk of death. A larger cohort is needed to evaluate efficacy of simultaneous IVC filter placement and PTE.

Indications for Inferior Vena Cava (IVC) Filter Placement - Assessing Compliance with Accepted Standards Set by Two Professional Societies

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2553-2553
Author(s):  
Amanjit S. Baadh ◽  
Stephen Rivoli ◽  
Jack Ansell ◽  
Robert E. Graham
Keyword(s):  
Internal Medicine ◽  
Interventional Radiology ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Ivc Filter ◽  
Filter Placement ◽  
Medical Specialties ◽  
Professional Societies ◽  
Ivc Filters

Abstract Abstract 2553 Background: Inferior Vena Cava (IVC) filter placement has increased significantly over the past few decades, due to expanding indications for filter placement. Indications for filter placement vary widely depending on which professional society recommendations are followed. Our objectives were to record the number of IVC filters placed in our medium sized metropolitan teaching hospital, assess the effect of medical specialty on placement and evaluate compliance with accepted standards as set by the American College of Chest Physicians (ACCP) and the Society of Interventional Radiology (SIR). Methods: Single-center, retrospective medical record review of all patients who received an IVC filter over 26 months (01/30/2008 - 4/5/2010). Inclusion criteria included patients from both sexes, all ages, filter placement within the aforementioned dates and inpatient procedures performed by interventional radiology. A total of 443 IVC filters were placed in our institution over the time period studied. 48.1% (213) of these filters were placed by interventional radiology. Of these, 187 were reviewed with 26 excluded do to incomplete patient records available at the time of review (July 2010). Medical records were reviewed for patient demographics, clinical course, and compliance with accepted guidelines set by the ACCP and SIR. Results: The average age was 75.3 years and 43.9% of the patients were males. 76.2% of patients were on the medical service (internal medicine and its subspecialties) whereas 22.8% were on non medical services. 87.2 % of filters were recommended by medicine and its subspecialties and 12.8% by non medical specialties. 43.3% of filters placed met guidelines established by the ACCP (Table 1). 79.1% of filters placed met SIR guidelines (Table 2). No documentation was available to assess compliance for 20.9% of filters. 46% of filters placed by internal medicine and its subspecialties met ACCP criteria whereas only 25% of filters recommended by non medicine specialties were compliant with criteria (p value=0.039, 95% CI). Physicians within internal medicine and its subspecialties were compliant with SIR guidelines for 84% of the filters placed, whereas only 46% of non medicine physicians met these indications (p=0.001, 95% CI). 35.8% of filters placed met SIR criteria but did not meet ACCP guidelines. Conclusions: Indications for IVC filter placement varied significantly in this study, less than half of filters placed met ACCP guidelines, yet over three-fourths met criteria set by the SIR, especially when comparing medicine and non medicine specialties. In analyzing the filters which meet indications set by SIR but not ACCP it becomes apparent that most of these are placed for patients classified as “fall risks”, failures of anticoagulation, limited cardiopulmonary reserve and medication noncompliance. Further research needs to be guided towards evaluating if these indications truly merit the placement of an IVC filter. This study strongly suggests a need for harmonization of current guidelines espoused by professional societies. A limitation of our study was that 230 filters placed by vascular surgery and interventional cardiology were not reviewed. Disclosures: No relevant conflicts of interest to declare.

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