Application of retrievable inferior vena cava filter placement in patients with deep venous thrombosis after fracture / 中国介入影像与治疗学

ABSTRACT

Objective To explore the value of retrievable inferior vena cava (IVC) filter placement for prevention of perioperative pulmonary embolism (PE) in patients with lower extremity/pelvic fracture with deep vein thrombosis (DVT).Methods Clinical data of 1 891 lower extremity/pelvic fracture patients combined with DVT were retrospectively analyzed.Totally 411 patients with permanent filters were excluded,and the other patients were divided into filter group (n=843) and control group (n=637) according to whether receiving retrievable IVC filter placement or not.The incidence of perioperative symptomatic PE and mortality were compared between the two groups.Results In filter group,Optease nonpermanent filters were inserted in 218 patients,and the mean indwelling time was (14.3±3.6) days.Celcet filters were inserted in 625 patients,and the filters were successfully removed in 566 out of 578 patients who underwent filter removal surgery (97.92％,566/578),and the mean indwelling time was (15.8±4.1) days.The incidence of PE in filter group (0.12％[1/843]) was significantly lower than that in control group (1.57％ [10/637],P＜0.05).Among the patients who received chemical anticoagulant therapy,the incidence of PE in filter group and control group was 0.14 ％ (1/700) and 1.47％(9/612),respectively (P＜0.05).Conclusion Retrievable IVC filter placement is a safe and effective method for preventing perioperative symptomatic and fatal PE in lower extremity/pelvic fracture patients with DVT.