Long-Term Results of Inferior Vena Cava Filters. Experiences in a Japanese Population.

Abstract

Objective In this prospective, non-controlled observational study, we evaluated the middle-to long-term results of placement of inferior vena cava (IVC) filter devices in Japanese patients.Methods and results In 42 Japanese patients with deep vein thrombosis (DVT) or pulmonary thromboembolism (PTE) who underwent percutaneous insertion of IVC filters, follow-up examinations at fixed intervals of 2 years were performed, and the data was evaluated including complications. There were no fatal complications during IVC filter implantation. About 5 %of patients with an inserted IVC filter developed symptomatic PTE, another 5 %devel-oped asymptomatic PTE. The trapped thrombus was demonstrated in about 22%of the inserted IVC filters. Lower rates of PTEdevelopment, occlusion of IVC, and captured thrombuswere found in the cases whereconcurrent use of anticoagulation therapy with filters was used. Trapped thrombi were found in half of IVC filters inserted prophylactically for proximal femoral venous thrombosis.Conclusion These experiences with IVCfilters suggest that they are safe and effective for the prevention of PTEin the Japanese population.

Vena Cava Filters in Cancer Patients: Experience With 50 Patients

“…We believe that this leads to lower rates of rethrombosis, thrombosis of the vena cava, or pulmonary embolism, and this is corroborated in the literature. 17,27 In our sample, we documented 1 case (0.5%) of symptomatic pulmonary thromboembolism. This is a lower rate than reported from other centers, where the rate has ranged from 2.5% to 33%.…”

“…This is a lower rate than reported from other centers, where the rate has ranged from 2.5% to 33%. 16,17,19,27,30,33 We also recorded 1 patient (0.5%) with thrombus retained in the filter and 2 patients (1%) with thrombosis of the inferior vena cava. These rates are much lower than found in some series: 10% to 22% and 7% to 24%, respectively.…”

“…There were no large-or small-scale complications, and this is in keeping with the findings from other published series. 19,26,27,28 The high rate of patient handling under general anesthesia was due to the fact that, in 16 cases, the implantation of the filter was on the same occasion as a largescale operation necessarily conducted under this type of anesthesia. When the blocking of the inferior vena cava was independently performed, local anesthesia concomitant with light sedation was preferred, so as to decrease the scale of anesthesia without causing discomfort to the patient.…”

“…These rates are much lower than found in some series: 10% to 22% and 7% to 24%, respectively. 19,27,30,33 It should be borne in mind that occlusion of the inferior vena cava could be considered to be a complication, possibly due to the presence of the foreign body in the lumen of the vessel, but it may also signify therapeutic success (retention of the thrombus), independent of whether the thrombus has a central or marginal position. No filter migrated in our patients, while such an occurrence may be found at a rate of more than 20%, in other reports.…”

“…No filter migrated in our patients, while such an occurrence may be found at a rate of more than 20%, in other reports. 27,30 The large number of patients who died can be explained by considering the fact that our sample consisted of patients with cancer that were mostly at an advanced stage, and thus these were individuals with a low life expectancy. It is emphasized that none of the 20 deaths could be attributed to the procedure of implanting the filter or to being a consequence of pulmonary thromboembolism, therefore showing the efficacy of the method.…”