Case Report

Removal of Vena Caval Filter at 224 Days

Authors: John C. Lipman, MD, FSIR

Abstract

Patients at risk of pulmonary embolism usually receive anticoagulants, which are contraindicated in trauma victims. A woman with extensive deep venous thrombosis after a vehicle accident had a nitinol Recovery Filter inserted prophylactically. After her recovery, she requested filter removal because of her intention to become pregnant. The filter was removed percutaneously without difficulty 224 days after implantation.


Key Points


* Prophylactic placement of a vena caval filter in patients at high risk of pulmonary embolism has been controversial.


* Certain optional vena caval filters may remain in place safely for extended periods.


* The benefit of inferior vena cava filtration with a removable filter is a significant step in the prevention of pulmonary embolism.

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References

1. Hirsh J, Hoak J. Management of deep vein thrombosis and pulmonary embolism: a statement for healthcare professionals: Council on Thrombosis (in consultation with the Council on Cardiovascular Radiology), American Heart Association. Circulation 1996;93:2212–2245.
 
2. Elliott CG, Dudney TM, Egger M, et al. Calf-thigh sequential pneumatic compression compared with plantar venous pneumatic compression to prevent deep-vein thrombosis after non-lower extremity trauma. J Trauma 1999;47:25–32.
 
3. Levine MN, Raskob G, Landefeld S, et al. Hemorrhagic complications of anticoagulant treatment.Chest 1998;114:511S–523S
 
4. Duperier T, Mosenthal A, Swan KG, et al. Acute complications associated with Greenfield filter insertion in high-risk trauma patients. J Trauma 2003;54:545–549.
 
5. Athanasoulis CA, Kaufman JA, Halpern EF, et al. Inferior vena caval filters: review of a 26-year single-center clinical experience. Radiology 2000;216:54–66.
 
6. Lorch H, Welger D, Wagner V, et al. Current practice of temporary vena cava filter insertion: a multicenter registry. J Vasc Interv Radiol 2000;11:83–88.
 
7. Burbridge BE, Walker DR, Millward SF. Incorporation of the Günther temporary inferior vena cava filter into the caval wall. J Vasc Interv Radiol 1996;7:289–290.
 
8. Darcy MD, Smith TP, Hunter DW, et al. Short-term prophylaxis of pulmonary embolism by using a retrievable vena cava filter. Am J Roentgenol 1986;147:836–838.
 
9. Millward SF. Temporary and retrievable inferior vena cava filters: current status. J Vasc Interv Radiol1998;9:381–387.
 
10. de Gregorio MA, Gamboa P, Gimeno MJ, et al. The Günther Tulip retrievable filter: prolonged temporary filtration by repositioning within the inferior vena cava. J Vasc Interv Radiol 2003;14:1259–1265.
 
11. Epstein DH, Darcy MD, Hunter DW, et al. Experience with the Amplatz retrievable vena cava filter.Radiology 1989;172:105–110.
 
12. Gosin JS, Graham AM, Ciocca RG, et al. Efficacy of prophylactic vena cava filters in high-risk trauma patients. Ann Vasc Surg 1997;11:100–105.
 
13. Velmahos GC, Kern J, Chan LS, et al. Prevention of venous thromboembolism after injury: an evidence-based report, II: analysis of risk factors and evaluation of the role of vena caval filters. J Trauma2000;49:140–144.
 
14. Rogers FB, Strindberg G, Shackford SR, et al. Five-year follow-up of prophylactic vena cava filters in high-risk trauma patients. Arch Surg 1998;133:406–411.
 
15. Recommended reporting standards for vena caval filter placement and patient follow-up: Vena Caval Filter Consensus Conference. J Vasc Surg 1999;30:573–579.
 
16. Asch MR. Initial experience in humans with a new retrievable inferior vena cava filter. Radiology2002;225:835–844.