Duplex ultrasound insertion of inferior vena cava filters in multitrauma patients

Benjamin, Marshall E.; Sandager, Gail P.; Cohn, Edwin J.; Halloran, Brian G.; Cahan, Mitchell A.; Lilly, Michael; Scalea, Thomas M.; Flinn, William R.

doi:10.1016/s0002-9610(99)00137-3

Cited by 39 publications

(19 citation statements)

References 33 publications

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“…This high-risk group is comprised of patients with spinal cord injuries, closed head injuries with prolonged immobilization, and pelvic or multiple fractures of the lower extremities. [9][10][11][12][13][14][15] Many of these individuals also have either a relative contraindication to anticoagulation therapy or an extremity injury that would preclude pneumatic compression devices. In recent years, prophylactic use of IVC filters in this population of patients has been described.…”

Section: Discussionmentioning

confidence: 99%

Duplex scan–directed placement of inferior vena cava filters: A five-year institutional experience

Conners

Becker

Guzman

et al. 2002

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Duplex scan–directed placement of inferior vena cava filters: A five-year institutional experience

Conners

Becker

Guzman

et al. 2002

Journal of Vascular Surgery

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“…The insertion of an inferior vena cava filter prophylactically reduces pulmonary embolism in patients at increased risk [4,5]. The decision to implant vena cava filters, either temporary or permanent, is difficult, especially in young patients [9], but the techniques for placement of inferior vena cava filters have undergone continued evolution from open surgical exposure of the venous insertion site to percutaneous insertion in most cases today [10]. Nevertheless, temporary cava filter positioning has commonly been suggested for a provisional period of time only.…”

Section: Discussionmentioning

confidence: 99%

Prolonged placement of the new temporary Montanari's vena cava filter

Praticò

Fodale

D'Amico

et al. 2005

TCIC

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Trauma patients are often at significant risk for venous thromboembolism, a multifactorial disease often manifesting clinically with pulmonary embolism, resulting in high morbidity and mortality rates. Multiple studies have reported the benefit of prophylactic positioning of inferior vena cava temporary filters, but these devices may only be placed for a relatively short time. In a 41-year-old man, admitted to the intensive care unit for multiple trauma, and at high risk for pulmonary embolism, the new definitive/temporary Montanari's vena cava filter (ALN) was positioned at the lower level of the renal veins, and maintained for ten months, much longer than is usual at the present time. The ALN filter was removed through the right jugular vein and no signs of alterations were noted in the removed device. At 1-year follow-up after the device removal, no related adverse events were seen. Since ALN filter does not require anticoagulant treatment, it was also possible to avoid administration of heparin, a high-risk treatment considering the patient's condition and the surgical treatment required.

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“…We have reported our experience with a group of consecutive multiply injured trauma and ICU patients who had IVC filters placed at the bedside, using DGFI. 32 We continue to use the technique, and to date used it in more than 100 multiply injured trauma patients.…”

Section: The Bedside Insertion Of Inferior Vena Cava Filters Using Ulmentioning

confidence: 99%

The Bedside Insertion of Inferior Vena Cava Filters Using Ultrasound Guidance

Uppal¹,

Flinn²,

Benjamin³

2007

Perspectives in Vascular Surgery and Endovascular Therapy

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Since the introduction of inferior vena cava (IVC) filters more than 30 years ago, there has been a steady improvement in the design, ease, and safety of the delivery systems. Today, all of the commonly used filters can be placed via a peripheral vein by using standard percutaneous Seldinger technique. However, this typically requires fluoroscopy, intravenous contrast agents, radiation exposure, and transport of the patient to the interventional or operating suite. In the multiply injured trauma or critically-ill intensive care unit patient, often requiring inotropic and ventilator support, transport to these facilities can be hazardous. In addition, these patients frequently have a combination of neurospinal and long bone injuries, which require skeletal immobilization, thus further complicating transportation. Advancing technology with portable duplex ultrasound and improved deep abdominal duplex imaging has allowed for routine diagnostic evaluation of the IVC, renal veins, and surrounding visceral structures. This degree of accuracy has allowed numerous centers to gain experience with ultrasonic imaging of the IVC and insertion site after a filter has been placed. A logical progression has evolved to the point in which, today, duplex ultrasound can be used to guide the insertion of IVC filters. The following describes, in detail, a technique for the percutaneous placement of an IVC filter at the bedside using only duplex ultrasound guidance. The article also briefly compares and contrasts this technique with an alternate technique using intravascular ultrasound. Vena caval interruption can be safely performed under ultrasound guidance in a monitored, intensive care unit environment. In selected intensive care unit or multiply injured trauma patients, this will reduce the risk, complexity and cost of transport for these critically ill patients. Duplex-guided IVC filter placement also reduces procedural costs compared to an operating room or interventional suite, and eliminates intravenous contrast material exposure.

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Duplex ultrasound insertion of inferior vena cava filters in multitrauma patients

Cited by 39 publications

References 33 publications

Duplex scan–directed placement of inferior vena cava filters: A five-year institutional experience

Duplex scan–directed placement of inferior vena cava filters: A five-year institutional experience

Prolonged placement of the new temporary Montanari's vena cava filter

The Bedside Insertion of Inferior Vena Cava Filters Using Ultrasound Guidance

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