Does prophylactic inferior vena cava filter reduce the hazard of pulmonary embolism and mortality in severe trauma? A single center retrospective comparative study

Tran, Thien Trung; Bjarnason, Haraldur; McDonald, Jennifer S.; Goss, Brian C.; Kim, Brian; Houghton, Damon E.; Stavem, Knut; Kløw, Nils Einar

doi:10.1016/j.ejro.2020.100299

Cited by 3 publications

(4 citation statements)

References 38 publications

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“…A heparina de baixo peso molecular (HBPM) é preferida em comparação a heparina não fracionada (HNF), por sua biodisponibilidade aprimorada, meia-vida mais longa e eficácia aprimorada contra o fator Xa, ao mesmo tempo em que induz menos efeito nas plaquetas e na permeabilidade microvascular, dois fatores que contribuem para a hemorragia relacionada à anticoagulação (XIAO; DESAI, 2021). Dessa forma, os filtros de veia cava têm sido considerados como uma alternativa razoável à profilaxia farmacológica em pacientes gravemente feridos (TRAN et al, 2020;XIAO;DESAI, 2021). Além disso, em casos de trombose maciça sintomática ou trombo progressivo em pacientes com contraindicação à colocação de filtros de VCI e anticoagulação pode-se considerar a trombectomia cirúrgica sem anticoagulação, dependendo diretamente do tamanho e localização do trombo (DIAB C, et al, 2017).…”

Section: Discussionunclassified

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Trombose extensa em veia cava desencadeada por trauma: um relato de caso

Teixeira,

Favero,

Sabino

et al. 2023

Braz. J. Hea. Rev.

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A trombose de veia cava inferior no trauma contuso é rara, com 3 a 10% dos casos. A tomografia computorizada é essencial no diagnóstico. A anticoagulação precoce é o padrão de tratamento. Objetivou-se relatar um caso de uma paciente do sexo feminino, de 33 anos, que sofreu um trauma abdominal durante uma colisão moto versus auto, com achado trombose de veia cava inferior e manejada com anticoagulação plena. Clinicamente, as lesões venosas traumáticas apresentam-se forma inespecífica e pode somente se revelar após EP súbita e fatal. Dessa forma, pacientes com trauma abdominal contuso devem ser avaliados para a possibilidade de trombose e tratados precocemente.

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Section: Discussionunclassified

“…Os pacientes vítimas de trauma possuem um risco aumentado de tromboembolismo venoso (TEV), incluindo trombose venosa profunda (TVP) e embolia pulmonar (EP). O risco aumentado decorre da presença dos fatores da tríade de Virchow: estase venosa, lesão endotelial e hipercoagulabilidade (TRAN et al, 2020).…”

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Trombose extensa em veia cava desencadeada por trauma: um relato de caso

Teixeira,

Favero,

Sabino

et al. 2023

Braz. J. Hea. Rev.

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“…Three observational retrospective studies of acceptable to low quality indicated more DVTs in patients with IVCFs, 45–47 and one of these observed more pulmonary embolisms in patients with an IVCF 45 . None of these studies screened patients routinely for DVT or pulmonary embolism and none showed a significant difference in survival.…”

Section: Vena Cava Filter In Trauma Patientsmentioning

confidence: 99%

European guidelines on peri-operative venous thromboembolism prophylaxis: first update.

Heim,

Bruder,

Davenport

et al. 2024

European Journal of Anaesthesiology

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Monitoring hypercoagulation in trauma patients RationaleIt is now well recognised that in the acute phase, after major trauma, the coagulation system is dynamic and, particularly in bleeding patients with trauma-induced coagulopathy or severe brain injury, a hypercoagulable phenotype develops universally within 24 to 48 h. 1 Achieving adequate venous thromboembolism prophylaxis (VTEp) in trauma patients remains challenging for several reasons and despite standardised protocols to administer low-molecular-weight heparin (LMWH), up to 18% of critically injured patients will develop deep venous thrombosis (DVT) or pulmonary embolism despite pharmacoprophylaxis. 2 Measuring serum anti-Xa levels has been proposed to help titrate VTEp, with consensus defining prophylactic anti-Xa levels as 0.2 to 0.4 IU ml À1 for peak measurements or 0.1 to 0.2 IU ml À1 for trough levels, with values below this being subprophylactic. 3 Studies have shown that prophylactic anti-Xa levels compared with subprophylactic levels predict the risk of a clinically significant VTE in trauma patients. [4][5][6] Two studies have reported that anti-Xa-guided dosing of LMWH reduces the rate of VTE after trauma compared with a standard fixed dose of enoxaparin. 7,8 However, a more recent large single centre study has failed to show any benefit of anti-Xa guided dosing for VTEp. 9 Weight-adjusted protocols for LMWH are used in published guidelines 10 based on a handful of studies demonstrating improved rates of prophylactic anti-FXa levels and overall lower VTE rates.

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“…Of 1451 patients identified, 282 received an IVC filter and results were compared to the control. There was no association with PE (HR=0.46; 95% CI, 0.12,1.70; P=0.24) or mortality (HR=1.02; 95% CI 0.60,1.75; P=0.93) after filter placement but there was association with DVT (HR = 2.73; 95 % CI, 1.28,5.85; P=0.01) [ 102 ].…”

Section: Reviewmentioning

confidence: 99%

Inferior Vena Cava Filters and Complications: A Systematic Review

Bajda,

Park,

Raj

et al. 2023

Cureus

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Inferior vena cava (IVC) filters have been used since the 1960s to treat patients with acute risk of pulmonary embolism (PE) to prevent migration of thrombus by trapping it within the filter. Traditional usage has been in patients with contraindication to anticoagulation that carry a significant mortality risk. In this systematic review, we sought to evaluate complications associated with placement of inferior vena cava filters based on published data from the past 20 years. A search was performed on October 6th, 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews, using three databases (ProQuest, PubMed and ScienceDirect) for articles published between the dates of February 1, 2002 and October 1, 2022. Results were filtered to include full-text, clinical studies, and randomized trials written in English pertaining to keywords “IVC filter AND complications”, “Inferior Vena Cava Filter AND complications”, “IVC filter AND thrombosis” and “Inferior Vena Cava Filter AND thrombosis”. Articles identified by the three databases were pooled and further screened for relevance based on inclusion and exclusion criteria. Initial search results yielded 33,265 hits from all three databases combined. Screening criteria were applied, with 7721 results remaining. After further manual screening, including removal of duplicate hits, a total of 117 articles were selected for review. While there are no consensus guidelines for best practice, there is compelling evidence that IVC filters can provide significant protection against PE with minimal complications if the treatment window is appropriate. Increase in the variety of filter models has led to broader availability, but skepticism remains about their efficacy and safety, with ongoing controversy surrounding appropriate indications. Further research is needed to establish clear guidelines on appropriate indications for IVC placement and to determine time course of complications versus benefits for indwelling filters.

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Does prophylactic inferior vena cava filter reduce the hazard of pulmonary embolism and mortality in severe trauma? A single center retrospective comparative study

Cited by 3 publications

References 38 publications

Trombose extensa em veia cava desencadeada por trauma: um relato de caso

Trombose extensa em veia cava desencadeada por trauma: um relato de caso

European guidelines on peri-operative venous thromboembolism prophylaxis: first update.

Inferior Vena Cava Filters and Complications: A Systematic Review

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