Thromboembolic Complications in Patients with Advanced Cancer: Anticoagulation Versus Greenfield Filter Placement

Calligaro, Keith D.; Bergen, William S. Van; Haut, Michael J.; Savarese, Ronald P.; DeLaurentis, Dominic A.

doi:10.1007/bf02016754

Cited by 70 publications

(47 citation statements)

References 15 publications

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“…Although cohort analyses reported apparent beneficial effects of vena caval filters, a large randomized study failed to demonstrate any long-term advantage [34].…”

Section: 8%; Common Odds Ratio (Or)mentioning

confidence: 99%

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Should Patients with Venous Thromboembolism and Cancer Be Treated Differently?

Smorenburg¹,

Hutten

Prins

1999

Pathophysiol Haemos Thromb

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Patients with malignant disease constitute a significant subgroup among patients with venous thromboembolism. Current results suggest that cancer patients are not only at an increased risk for thromboembolic events, particularly during chemotherapy treatment or after surgery, they also have an increased risk for bleeding complications while receiving oral anticoagulant treatment. The exact incidences of venous thromboembolic complications for the various types of cancer, however, are not well determined. Recent studies have indicated that subcutaneous low-molecular-weight heparin (LMWH) is as safe and effective as intravenous unfractionated heparin (UFH) in the initial treatment of venous thromboembolism. Moreover, a meta-analysis has provided preliminary evidence that, compared with UFH, LMWH treatment may prolong survival in cancer patients. Initiation of LMWH treatment in these patients is, therefore, recommended. Prospective randomized clinical trials to assess the optimum dose and duration of therapy are called for.

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“…Although cohort analyses reported apparent beneficial effects of vena caval filters, a large randomized study failed to demonstrate any long-term advantage [34].…”

Section: 8%; Common Odds Ratio (Or)mentioning

confidence: 99%

“…The use of vena caval filters instead of anticoagulant treatment in patients with cancer has been evaluated in various trials [34][35][36][37]. Although cohort analyses reported apparent beneficial effects of vena caval filters, a large randomized study failed to demonstrate any long-term advantage [34].…”

Section: 8%; Common Odds Ratio (Or)mentioning

confidence: 99%

Should Patients with Venous Thromboembolism and Cancer Be Treated Differently?

Smorenburg¹,

Hutten

Prins

1999

Pathophysiol Haemos Thromb

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“…17,18,19 Recently, however, with the development of endovascular materials and techniques, there has been an even greater willingness to indicate this procedure. 20,21 Some authors, such as Cohen 22 and Calligaro, 23 have proposed implantation of such filters as the first-choice method for oncological patients with DVT. Such proposals have also been based on studies that have demonstrated that these patients are at greater risk of hemorrhagic events than nononcological patients.…”

Section: Discussionmentioning

confidence: 99%

Vena Cava Filters in Cancer Patients: Experience With 50 Patients

Zerati

Wolosker

Yazbek

et al. 2005

Clinics

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OBJECTIVE:To study the immediate and late results obtained from the implantation of vena cava filters in cancer patients with deep vein thrombosis concomitant with neoplasia. METHODS: This was a retrospective evaluation of 50 patients with an association of cancer and deep venous thrombosis who underwent interruption of the inferior vena cava and the insertion of permanent vena cava filters. The indications for the procedure, filter implantation technique, early and late complications related to the operation, and the clinical evolution were evaluated. RESULTS: The most frequent indication for filter implantation was the contraindication for full anticoagulant treatment (80%). The femoral vein was the preferred access route (86% of the patients). There were no complications related to the surgical procedure. During the follow-up, the following complications were observed: 1 episode of nonfatal pulmonary thromboembolism, 2 cases of occlusion of the inferior vena cava, and 1 case of thrombus retained in the device. Twenty patients (40%) died due to progression of the neoplasm. CONCLUSIONS: Interruption of the inferior cava vein using an endoluminal filter is a procedure with a low rate of complications. It is a safe and efficient measure for preventing pulmonary embolism in cancer patients who have deep vein thrombosis of the lower limbs.

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“…Unfractionated heparin (UH) or low molecular weight heparins (LMWH) with early introduction of vitamin K antagonist (VKA) Three retrospective studies [12,13,17] and the control arm of a randomised multicentre study [28] show that unfractionated heparin (UFH) followed by long-term VKA therapy is associated with an unacceptable rate of recurrence (10% to 30%) and severe bleeding. As observed in the general population, the use of LMWH to start anticoagulation allowed significant progress in treating DVT and PE in cancer patients.…”

Section: Treatment Of Established Vte In Cancer Patientsmentioning

confidence: 99%