An evaluation on complications following the placement of permanent inferior vena cava filters / 中国微创外科杂志

ABSTRACT

Objective To investigate the causes of and preventive measures for complications following the placement of permanent inferior vena cava filter (VCF). Methods A total of 71 patients, with proven diagnosis of lower limb deep vein thrombosis (DVT) by Doppler ultrasonography, underwent the placement of permanent VCF from December 1999 to June 2003. Forty of the patients were acute lower limb DVT. Cavography was performed routinely during operation to confirm no thrombosis in inferior vena cava and access veins. The insertion site of filters was below the renal veins. Four types of permanent VCF were used Titan-Greenfield filters, Simon-Nitinol filters, LGM filters and TrapEase filters. Anticoagulation treatments were used in all the cases post-VCF insertion. Results The placement of VCFs was successfully accomplished in all the cases in the study. Follow- up observations for 1～41 months revealed vena cava thrombosis at the site of insertion in 2 cases and filter tilting less than 15? in 5 cases. There were no events of filter migration, filter fracture, vessel wall perforation, filter embolism or access vein thrombosis, as well as pulmonary embolism (PE). Conclusions Different types of VCFs have different kinds of complications and their incidence rates. Preoperative ultrasonography and intraoperative cavography should be performed to evaluate the vena cava and access vein. Careful surgical management and strict anticoagulation therapy are the key to the successful VCF placement and the prevention of PE or other complications.