Clinical outcome and complications of temporary inferior vena cava filter placement

Miyahara, Takuya; Miyata, Tetsuro; Shigematsu, Kunihiro; Deguchi, Juno; Kimura, Hideo; Ishii, Shigeyuki; Nagawa, Hirokazu

doi:10.1016/j.jvs.2006.05.019

Cited by 71 publications

(57 citation statements)

References 18 publications

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“…Contraindications to anticoagulation therapy were reported only in 9.1% of cases. 12 Similarly, thrombolysis was performed at a high rate (20.9%), which contrasts with the infrequent application of this technique in Western countries, as indicated in the RIETE (1.2%); this finding deviates from the recommendations of international and Japanese guidelines.…”

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confidence: 92%

Current Venous Thromboembolism Management and Outcomes in Japan

Nakamura

Miyata

Ozeki

et al. 2014

Circ J

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114

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mentioning

confidence: 92%

Current Venous Thromboembolism Management and Outcomes in Japan

Nakamura

Miyata

Ozeki

et al. 2014

Circ J

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114

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“…A temporary IVC filter is often used to avoid perioperative recurrence of PE, 13 but filter-related complications sometimes occur 14 and PE is an important one. 15 Thrombosis may occur at the insertion site or the site of the filter itself.…”

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confidence: 99%

Recurrence of Pulmonary Embolism in Young Man With Retroperitoneal Tumor Despite Insertion of Temporary IVC Filter

Natsuaki

Numaguchi

Tada

et al. 2009

Circ J

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A 21-year-old man was admitted to our hospital for acute chest pain and dyspnea. On arrival, his blood pressure was 110/40 mmHg and heart rate was 112 beats/min. In the arterial blood gas analysis, pH was 7.43, PaCO2 was 31 mmHg, and PaO2 was 92 mmHg under 10 L/min oxygen inhalation. In the blood tests, blood cell count and renal functions were normal, but lactate dehydrogenase and C-reactive protein levels were high at 590 IU/L and 3.7 mg/dl, respectively. Of the coagulation values, the d-dimer level was high (13.7 μg/ml), and ATIII activity was slightly low (60%), but the activities of protein C and protein S were normal. Plain chest X-ray showed mild pulmonary artery dilatation. Ultrasonic cardiogram (UCG) showed right ventricle overload and pulmonary hypertension (estimated systolic pulmonary artery pressure 60 mmHg). We suspected pulmonary embolism (PE), and performed contrast computed tomography (CT), which revealed massive thrombi in both pulmonary arteries ( Figure 1A). Bilateral perfusion defects were found on perfusion scintigraphy of the lung ( Figure 1B), and we diagnosed PE. In addition, abdominal CT showed a retroperitoneal tumor approximately 10×5 cm (Figure 2A). The inferior vena cava (IVC) was obstructed by the tumor and thrombus existed in the right common iliac vein. We started thrombolysis (urokinase 240,000 U/day for 5 days) followed by heparinization (48,000 U/day). We controlled the APTT at 60-80 s. Under this therapy, his oxygen saturation and symptoms improved each day and on the 3 rd day, arterial blood gas analysis showed that pH was 7.43, PaCO2 was 40 mmHg, and PaO2 was 88 mmHg under room air. The pulmonary artery pressure had also decreased on UCG (estimated systolic pulmonary artery Japan. E-mail: natsuaki@saiseikai-hp.chuo.fukuoka.jp All rights are reserved to the Japanese Circulation Society. For permissions, please e-mail: cj@j-circ.or.jp Recurrence of Pulmonary Embolism in Young Man With Retroperitoneal Tumor Despite Insertion of Temporary IVC FilterMasahiro Natsuaki, MD; Kotaro Numaguchi, MD; Hideo Tada, MD*; Yuichiro Nakashima, MD**; Masanori Okabe, MD; Yusuke Yamamoto, MD Pulmonary embolism (PE) is a fatal disease that is very rare in young people. A 21-year-old man developed PE because of a retroperitoneal tumor. The inferior vena cava (IVC) was obstructed by the tumor, and thrombus existed in the right common iliac vein. Thrombolysis and heparinization improved his symptoms prior to urgent tumor resection. A temporary IVC filter was inserted the day before the operation, but 8 h later fatal massive PE occurred. At autopsy, the retroperitoneal tumor was revealed as a metastatic choriocarcinoma. Prophylactic use of a temporary IVC filter might have paradoxically induced recurrence of massive PE in this case. (Circ J 2009; 73: 1756 -1758

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“…16 Recently, temporary filters have been used to reduce the recurrence of PE in the acute phase, especially in Japan, but adverse effects may result (ie, infection, obstruction of filters, hematoma at insertion site). 17,18 Further precise indications for filters for the prevention of PE with high risks are required. Kucher et al reported that IVC filters were associated with a reduction in 90-day mortality in massive PE, 8 and several reports suggest that submassive PE because of RV dysfunction on echocardiography or CT identifies high-risk patients.…”

Section: Discussionmentioning

confidence: 99%

Multidetector-Row Computed Tomography Management of Acute Pulmonary Embolism

Yasui

Tanabe

Terada

et al. 2007

Circ J

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ge-adjusted mortality rates of pulmonary embolism (PE) increased significantly between 1951 and 2000, and the rate of successful treatment of acute PE has been increasing in Japan. 1 Three clinical surveys have been performed by Tohoku University and the calculated number of new patients with pulmonary thromboembolism in Japan has been increasing, the most recent total being 4,108 (3.22 per 100,000). 2 Mutidetector-row computed tomography (MDCT) is now widely available, making it possible to directly visualize thrombus and enabling alternative diagnoses. The clinical validity of using MDCT and D-dimer to rule out PE has been reported, 3 and recently, the results of the largest study (PIOPED II study) using either MDCT pulmonary angiography (MDCTA) or MDCTA combined with indirect venography (MDCTA-CTV) were reported, 4 showing that MDCTA-CTV had a higher sensitivity than MDCTA alone, with similar specificity. However, MDCTA-CTV was inconclusive in 10.6% of patients because of poor image quality of either CTA or CTV. 4 Several reports have suggested that right ventricular (RV) dysfunction assessed by MDCT helped predict mortality during follow-up, 5-7 and it is possible to evaluate RV dysfunction indicating submassive PE without echocardiography.Kucher et al reported a reduction in mortality from the use of inferior vena cava (IVC) filters in massive PE, 8 and Sakuma et al reported that several patients died of recurrence with submassive PE and even with non-massive PE. 9 Since 2003, we have routinely placed IVC filters in patients with massive or submassive PE with extensive deep venous thrombosis (DVT) on MDCTA-CTV. Echocardiography is used to assess RV dysfunction at that time. In the present study, the RV to left ventricular (LV) short-axis diameter (RVD/LVD) was also calculated by MDCT, and the patients were reclassified: RVD/LVD >1.0 was regarded as RV dysfunction (submassive PE) according to van der Meer et al. 5 The purpose of this study was to evaluate the usefulness and safety of MDCTA-CTV-oriented management of acute PE, including IVC filter indication. Methods PatientsBetween January 2003 and December 2005, 71 consecutive inpatients and outpatients (26 males, 45 females; mean age 58±17 years, range 17-86) suspected of having acute PE and who had not undergone diagnostic testing for PE were enrolled. Exclusion criteria were contraindication to the use of iodine contrast material (eg, history of allergy to contrast medium, renal insufficiency, pregnancy). All patients underwent MDCTA and indirect venography within 1 week from onset. 1948 -1954)

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Clinical outcome and complications of temporary inferior vena cava filter placement

Abstract: Temporary IVC filters were effective for the prevention of fatal pulmonary embolism. However, our experience of a high incidence of complications related to temporary filters suggests that this device has limited indications and supports the need for innovative design of temporary filters.

Cited by 71 publications

References 18 publications

Current Venous Thromboembolism Management and Outcomes in Japan

Current Venous Thromboembolism Management and Outcomes in Japan

Recurrence of Pulmonary Embolism in Young Man With Retroperitoneal Tumor Despite Insertion of Temporary IVC Filter

Multidetector-Row Computed Tomography Management of Acute Pulmonary Embolism

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