Therapeutic and Prophylactic Vena Caval Interruption for Pulmonary Embolism: Caval and Venous Insertion Site Patency

AbuRahma, Ali F.; Robinson, Patrick; Boland, James P.; Cochran, R.C.; Conley, Yale D.; Snodgrass, Kevin R.; Witsberger, Todd A.; Wood, D.J.

doi:10.1007/bf02000151

Cited by 10 publications

(3 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thrombotic occlusion of the vena cava has been observed in 27% or more,5 although a recent follow up reports 88% patency in survivors. 32 Operative vena caval plication is best undertaken through a transperitoneal approach, which gives better access to the juxtarenal vena cava than is possible through a limited retroperitoneal dissection. The risk of haemorrhage in the postoperative phase after transperitoneal dissection is also less in anticoagulated patients than following an extraperitoneal dissection.…”

Section: Vena Cava Interruptionmentioning

confidence: 99%

Early and Late Results After Bird's Nest Filter Placement in the Inferior Vena Cava: Clinical and Duplex Ultrasound Follow Up

Lord

Benn

1994

Australian and New Zealand Journal of Surgery

View full text Add to dashboard Cite

From February 1989 to November 1992, 61 Bird's Nest filters were placed in the infrarenal vena cava in 61 patients (36 men and 25 women; mean age ± s.d., 63 ± 15, range (16–83). In 27 (44.3%). the filter was inserted because of contraindication to anticoagulation, in 19 (31.1%) for anticoagulation failure and in 15 (24.6%) as prophylaxis against pulmonary embolism in high risk patients. All the filters were introduced by percutaneous puncture of the femoral vein after preliminary screening venography demonstrated that the iliac vein was free of thrombus. Two deaths occurred within 24 h of filter placement (periprocedure mortality 3.3%) while five other patients died within 1 month (30 day cumulative mortality 11.5%). At follow up, 2–40 months later (mean ± s.d., 17 ± 9), a further 13 patients had died (cumulative mortality 32.8%). At 36 months, the probability of survival, calculated by the Kaplan‐Meier Product Limit Method, was 55% (95% confidence intervals 37–74%). Apart from the two patients dying within 24 h, none of the early or late deaths were attributable to the procedure and there were no recurrent pulmonary emboli. Thirty‐seven of the surviving 41 patients were recalled for clinical examination and Duplex ultrasound interrogation of the vena cava and the lower limb veins. No new venous thromboses in the legs were observed and no increase or onset of leg swelling was reported. The vena cava patency was 100% in these 37 patients. Considering that the annual attack rate for deep venous thrombosis in New South Wales, Australia is 60 per 100000, and for pulmonary embolism 45 per 100000, vena caval filter placement is an effective but underused resource.

show abstract

Section: Vena Cava Interruptionmentioning

confidence: 99%

Early and Late Results After Bird's Nest Filter Placement in the Inferior Vena Cava: Clinical and Duplex Ultrasound Follow Up

Lord

Benn

1994

Australian and New Zealand Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…7,9,1222,23 There is also a higher rate of thrombosis with earlier vena cava filters due to larger introducers.7,24 Pais et al have shown that even though 33% of these thromboses were found on duplex studies, only 12% were clinically apparent.22 According to Hye et al, only 5% were apparent as long-term femoral vein thromboses.25 In addition, AbuRahma et al have shown, in a study including 161 patients, no jugular vein thromboses from percutaneous insertions. 23 With the exception of the jugular approach, it seems that a certain amount of venous thrombosis must be tolerated. With the equivalence of the 2 procedures, this allows the surgeon the ability to choose either technique without the concern of additional complications.…”

Section: Discussionmentioning

confidence: 99%

Insertion Technique and Placement Site for Greenfield Filters: Does it Make Any Difference?

Kopatsis¹,

Solis²,

Cernaianu³

et al. 1999

Vascular Surgery

View full text Add to dashboard Cite

The clinical outcome and complication rates related to the choice of technique and insertion site in the placement of a Greenfield filter (GFF) is still controversial. Moreover, there is no consensus as to which technique and placement site produces the best outcome. This study evaluated the charts of 364 patients who received GFFs during a 5year period. Seventy-one filters were placed surgically and 293 were placed percutaneously in the operating room by general and vascular surgeons. Seventy-eight were placed using the femoral approach and 296 were placed using the jugular approach. Demographics were recorded as well as preoperative, intraoperative, and postoperative variables. All immediate complications were examined including failure of the GFF to open, suboptimal placement, multiple attempts at placement, abandoned procedures, guidewire related difficulties, hematoma, bleeding, phlegmasia cerulea dolens, pneumothorax, arrhythmia, and death. There was no statistically significant difference between complications derived from surgical placement versus percutaneous placement. There were no statistically significant differences among variables based on jugular versus femoral placement. There was a statistically significant difference in the time required for the percutaneous placement versus the open surgical procedure (33 ± 28 min. vs 45 ±27 min., p<0.05). These findings suggest that the technique and site of the GFF insertion can be left to the discretion of the surgeon based on each patient's profile. 15 From the

show abstract

“…21 In spite of conflicting data from the literature, filters are inserted for so-called extended indications or PE prophylaxis in a significant number of patients: 24 to 37% in some series. 5,6,22 Contraindications to filter placement (Table 3)…”

mentioning

confidence: 99%

Vena Cava Filters

Namyslowski¹

2001

Semin intervent Radiol

View full text Add to dashboard Cite

Therapeutic and Prophylactic Vena Caval Interruption for Pulmonary Embolism: Caval and Venous Insertion Site Patency

Cited by 10 publications

References 14 publications

Early and Late Results After Bird's Nest Filter Placement in the Inferior Vena Cava: Clinical and Duplex Ultrasound Follow Up

Early and Late Results After Bird's Nest Filter Placement in the Inferior Vena Cava: Clinical and Duplex Ultrasound Follow Up

Insertion Technique and Placement Site for Greenfield Filters: Does it Make Any Difference?

Vena Cava Filters

Contact Info

Product

Resources

About