Long-term safety and effectiveness of inferior vena cava filters in patients with stroke

Somarouthu, Bhanusupriya; Yeddula, Kalpana; Wicky, Stéphan; Hirsch, Joshua A; Kalva, Sanjeeva P.

doi:10.1136/jnis.2010.004564

Cited by 16 publications

(13 citation statements)

References 26 publications

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“…In a seven-year retrospective study by Somarouthu et al, results showed that IVC filter placement in stroke patients resulted in imaging confirmed PE at a frequency of 4% and post-filter imaging confirmed DVT occurred in 14% of patients. They concluded that IVC filters have an adequate safety profile and are efficient in preventing fatal PE in patients with stroke [20].…”

Section: Discussionmentioning

confidence: 99%

Treating Venous Thromboembolism Post Intracranial Hemorrhage: A Case Report

Ajmeri

Zaheer

McCorkle

et al. 2020

Cureus

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Venous thromboembolism (VTE) is a significant issue occurring due to genetic, acquired and circumstantial risk factors. Treatment is according to the clinical situation and judgment for long term anticoagulation based on individual risk. Anticoagulation after a history of a hemorrhagic stroke poses a therapeutic dilemma. We present a case of a 68-year-old male who presented with right-sided chest pain and shortness of breath. Workup included a CT that was positive for multiple right-sided pulmonary emboli (PE). The patient has a past medical history of Factor V Leiden Mutation, recurrent PE, and deep vein thrombosis (DVT). Two months prior he was diagnosed with a 1.3-cm intracranial hemorrhage (ICH) from multiple cavernous angiomas. At that time his warfarin was discontinued and an inferior vena cave (IVC) filter was placed. Facing the recent ICH and now multiple and recurrent PE, it was decided to resume anticoagulation based on ICH location. ICH from a deep source is likely a better characteristic that favors a resumption of anticoagulation. Our case will highlight that IVC filters cannot be solely relied upon in patients that are at high risk for thrombotic events with underlying genetic thrombophilia.

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Section: Discussionmentioning

confidence: 99%

Treating Venous Thromboembolism Post Intracranial Hemorrhage: A Case Report

Ajmeri

Zaheer

McCorkle

et al. 2020

Cureus

View full text Add to dashboard Cite

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“…Certain patients, such as spinal cord injury patients and stroke patients, remain at high risk of VTE that is due to immobility, and permanent IVC filters may therefore be considered in these patients. IVC filters have been found to be safe in patients with nonhemorrhagic stroke, and certain authors have advocated for prophylactic filter placement in stroke patients; however, no guidelines currently advocate for prophylactic filter placement in stroke [65].…”

Section: Prophylacticmentioning

confidence: 99%

ACR Appropriateness Criteria® Radiologic Management of Venous Thromboembolism-Inferior Vena Cava Filters

Minocha

Smith

Kapoor

et al. 2019

Journal of the American College of Radiology

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Venous thromboembolism (VTE)-deep vein thrombosis and pulmonary embolism-is a common cause of morbidity and mortality. The mainstay of VTE prophylaxis and therapy is anticoagulation. In select patients with VTE, inferior vena cava (IVC) filters are used to prevent pulmonary embolism by trapping emboli as they pass from the lower extremity venous system through the IVC. These guidelines review the indications for placement of IVC filters in acute and chronic VTE, as well as the indications for retrieval of implanted IVC filters.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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“…However, once a PE or symptomatic DVT is diagnosed in patients with ischaemic stroke, full therapeutic anticoagulation is recommended [50]. In patients with an intracerebral haemorrhage, a vena cava filter might be an alternative [53], but this also requires anticoagulation in the longer term.…”

Section: Acute Stroke Carementioning

confidence: 99%

Management of Acute Stroke in the Older Person

2017

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Abstract:The majority of people who suffer a stroke are older adults. The last two decades have brought major progress in the diagnosis and management of stroke, which has led to significant reductions in mortality, long-term disability, and the need for institutional care. However, acute, interventional and preventative treatments have mostly been trialled in younger age groups. In this article we will provide an overview of the evidence for acute stroke treatments in relation to age, discuss special considerations in the older person, and contemplate patient choice, quality of life, and end-of-life-decisions.

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Long-term safety and effectiveness of inferior vena cava filters in patients with stroke

Abstract: IVC filters have an acceptable safety profile in stroke patients. In our cohort, they were effective in preventing life-threatening PE.

Cited by 16 publications

References 26 publications

Treating Venous Thromboembolism Post Intracranial Hemorrhage: A Case Report

Treating Venous Thromboembolism Post Intracranial Hemorrhage: A Case Report

ACR Appropriateness Criteria® Radiologic Management of Venous Thromboembolism-Inferior Vena Cava Filters

Management of Acute Stroke in the Older Person

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