Pulmonary Embolism after IVC Filter

Urban, Mi­chael; Jules-Elysée, Kethy M.; MacKenzie, C. Ronald

doi:10.1007/s11420-007-9071-2

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…This outcome has been described in previous reports and can occur in the setting of an unrecognized upper extremity DVT, collateral venous channels, or a clot forming on the proximal portion of the filter. 24,35,36 Regardless, there is little consensus regarding postoperative VTE prophylaxis for spinal surgery as evidenced by a recent study showing that the 63% of surgeons base their decisions for VTE prophylaxis on personal experience. 37 This study does have several limitations.…”

Section: Discussionmentioning

confidence: 99%

Thromboembolic Disease after Cervical Spine Surgery: A Review of 5,405 Surgical Procedures and Matched Cohort Analysis

Sebastian

Currier

Clarke

et al. 2015

Global Spine Journal

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Study Design Retrospective matched cohort analysis.Objective The majority of the literature on venous thromboembolism (VTE) after spine surgery is limited to studies of thoracolumbar surgery. Less is known regarding the incidence of VTE and associated risk factors following cervical spine surgery.Methods A total of 5,405 patients at our institution underwent cervical diskectomy, laminectomy, corpectomy, laminoplasty, or fusion between 1995 and 2012; 85 of the 5,405 patients (1.57%) suffered either a DVT (55) or pulmonary embolus (51) within 30 days postoperatively. The cases were matched 1:2 to controls based on age, sex, and date of surgery. Data regarding multiple perioperative factors, demographics, and comorbidities was collected.Results Several risk factors were identified for VTE. Significant medical comorbidities included chronic venous insufficiency (odds ratio [OR] = 3.40), atrial fibrillation (OR = 2.69), obesity (OR = 2.67), and ischemic heart disease (OR = 2.18). Staged surgery (OR = 28.0), paralysis (OR = 19.0), combined approach (OR = 7.46), surgery for infection (OR = 18.5), surgery for trauma (OR = 11.1), comorbid traumatic injuries (OR > 10), oncologic procedures (OR = 5.2), use of iliac crest autograft (OR = 4.16), two or more surgical levels (OR = 3.48), blood loss > 300 mL (OR = 1.66), and length of stay 5 days or greater (OR = 3.47) were all found to be risk factors for VTE (p < 0.05) in univariate analysis. Multivariate analysis found staged surgery (OR = 35.7), paralysis (OR = 7.86), and nonelective surgery (OR = 6.29) to be independent risk factors for VTE.Conclusions Although the incidence of VTE following cervical spine surgery is low, we identified several risk factors that may be predictive. More aggressive approaches to prophylaxis and surveillance in certain patient populations may be warranted.

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Section: Discussionmentioning

confidence: 99%

Thromboembolic Disease after Cervical Spine Surgery: A Review of 5,405 Surgical Procedures and Matched Cohort Analysis

Sebastian

Currier

Clarke

et al. 2015

Global Spine Journal

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“…It is a well-known phenomenon that IVC foreign bodies serve as a nidus for thromboembolism. This phenomenon has been extensively studied with IVC filters with a reported incidence of 6.2% 13. However, paradoxically IVC filters have also been used as treatment for cement emboli in IVC to prevent pulmonary migration 6…”

Section: Discussionmentioning

confidence: 99%

A rare nidus for pulmonary thromboembolism after vertebroplasty

et al. 2013

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Percutaneous vertebroplasty is used to treat osteoporotic compression fractures and bone loss due to malignancy. The cement used can serve as a potential nidus for pulmonary thromboembolism (PTE). An 87-year-old woman with recent L2 vertebroplasty presented with abdominal pain and shortness of breath. Thoracoabdominal CT scan revealed extensive bilateral pulmonary emboli associated with a 9 cm cement fragment in the inferior vena cava (IVC) extending proximally from the level of the right superior renal vein, likely secondary to cement leak from the vertebral plexus into the IVC. She refused catheter extraction was managed conservatively. There are 51 reported cases of cement pulmonary embolism. IVC foreign bodies serving as a nidus for PTE have been reported with IVC filters with an incidence of 6.2%. This is the second reported case of vertebroplasty cement serving as a nidus for PTE. Treatment depends on time interval between the procedure and the symptom onset.

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Pulmonary Embolism after IVC Filter

Cited by 2 publications

References 15 publications

Thromboembolic Disease after Cervical Spine Surgery: A Review of 5,405 Surgical Procedures and Matched Cohort Analysis

Thromboembolic Disease after Cervical Spine Surgery: A Review of 5,405 Surgical Procedures and Matched Cohort Analysis

A rare nidus for pulmonary thromboembolism after vertebroplasty

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