Prophylactic Greenfield filter placement in selected high-risk trauma patients

Abstract

PGF insertion in selected patients at high risk who had trauma effectively prevented both fatal and nonfatal PE. The lower incidence of fatal PE in the PGF group may have contributed to a reduction in the overall mortality rate. Patients who have trauma with high risk for PE should be considered for PGF placement.

The Effectiveness of Prophylactic Inferior Vena Cava Filters in Trauma Patients

“…Fifty-eight studies addressed IVC filter use in trauma, although most (n = 48) were uncontrolled studies. We included 8 controlled studies that assessed the effectiveness of IVC filter compared with no filter placement on VTE events in trauma patients ( ; 4, prospective cohort studies with historical controls 27,[29][30][31] ; and 1, a retrospective cohort study.…”

“…25,27,28,[30][31][32] We In the small RCT, 25 we found no statistically significant difference in the incidence of PE between the 2 groups, with no PEs in the IVC filter group and 1 PE among patients without filters. Five of the 6 observational studies included in the metaanalysis reported lower PE rates with IVC filter placement [27][28][29][30][31] ( …”

“…We included 4 studies that reported on fatal PE 25,27,30,31 ; one of these had no events in either arm 25 ( Figure 3). We found consistent evidence of a reduction in fatal PE with IVC filters the precise and consistent evidence of a reduction in fatal PE with IVC filters, sensitivity analyses with alternative continuity corrections (used if 0 events occurred in 1 treatment arm) were not uniformly robust to the outcome of fatal PE.…”

Indications, management, and complications of temporary inferior vena cava filters

“…The IVC wall was penetrated in 9%, and PE with a filter in place developed in up to 10%; 6% of permanent IVC filters migrated and filter fractures were observed in 2% (Table 1). In view of these data, the indiscriminant prophylactic use of permanent IVC filters should be avoided [2,[4][5][6][7][8].…”

Prophylactic Insertion of Optional Vena Cava Filters in High-Risk Trauma Patients

“…Inferior VCFs are effective in preventing PE [17][18][19], but they do not prevent DVT or postthrombotic syndrome. In high-risk trauma patients without DVT, prophylactic insertion of a VCF has shown to decrease the rate of PE in multiple studies [20][21][22]. Interruption of the inferior vena cava (IVC) for the prevention of PE has become popular in trauma patients.…”