Impact of Anticoagulation in Elderly Patients With Pulmonary Embolism That Undergo IVC Filter Placement: A Retrospective Cohort Study

Falatko, John; Dalal, Bhavinkumar; Qu, Lihua

doi:10.1016/j.hlc.2017.01.011

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…Moreover, even in the cases when IVC filters are indicated and beneficial, it is important to note that the longer they remain indwelling, the more complications begin to accumulate. A majority of research concurs that there is positive correlation between indwelling time and complication rate, so it's important to keep in mind the relatively high rate of retrievable filters that are not retrieved [12,25,26,37,39,43,44,[121][122][123][124][125][126][127][128][129][130][131][132][133][134]. Finally, as has been mentioned in many studies regarding IVC filters, there remains a need for randomized control trials to determine their efficacy, particularly in regard to some of the expanding indications included in this review.…”

Section: Discussionmentioning

confidence: 99%

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Inferior Vena Cava Filters and Complications: A Systematic Review

Bajda,

Park,

Raj

et al. 2023

Cureus

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Inferior vena cava (IVC) filters have been used since the 1960s to treat patients with acute risk of pulmonary embolism (PE) to prevent migration of thrombus by trapping it within the filter. Traditional usage has been in patients with contraindication to anticoagulation that carry a significant mortality risk. In this systematic review, we sought to evaluate complications associated with placement of inferior vena cava filters based on published data from the past 20 years. A search was performed on October 6th, 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews, using three databases (ProQuest, PubMed and ScienceDirect) for articles published between the dates of February 1, 2002 and October 1, 2022. Results were filtered to include full-text, clinical studies, and randomized trials written in English pertaining to keywords “IVC filter AND complications”, “Inferior Vena Cava Filter AND complications”, “IVC filter AND thrombosis” and “Inferior Vena Cava Filter AND thrombosis”. Articles identified by the three databases were pooled and further screened for relevance based on inclusion and exclusion criteria. Initial search results yielded 33,265 hits from all three databases combined. Screening criteria were applied, with 7721 results remaining. After further manual screening, including removal of duplicate hits, a total of 117 articles were selected for review. While there are no consensus guidelines for best practice, there is compelling evidence that IVC filters can provide significant protection against PE with minimal complications if the treatment window is appropriate. Increase in the variety of filter models has led to broader availability, but skepticism remains about their efficacy and safety, with ongoing controversy surrounding appropriate indications. Further research is needed to establish clear guidelines on appropriate indications for IVC placement and to determine time course of complications versus benefits for indwelling filters.

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Section: Discussionmentioning

confidence: 99%

“…The study concludes that the effect of anticoagulation was not significant in this cohort and notes age as a major confounding factor. Although anticoagulation is the treatment of choice for prevention of acute PE, in the elderly population there may be diminishing benefits [ 129 ].…”

Section: Reviewmentioning

confidence: 99%

Inferior Vena Cava Filters and Complications: A Systematic Review

Bajda,

Park,

Raj

et al. 2023

Cureus

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“…Of course, we can implant a VCF into our patient to overcome the period of absolute contraindications for anticoagulation. We conducted a search of the literature in PubMed using the search criteria “pulmonary embolism” and “contraindication of anticoagulation” and finally found that VCF is a potential strategy to prevent recurrence of PE in patients with contraindications for anticoagulant therapy [6,7] and most patients with PE like our case choose to implant a VCF. Conversely, withholding treatment may be associated with fewer adverse events than treatment with anticoagulants or a VCF in patients with nonmassive acute PE.…”

Section: Discussionmentioning

confidence: 99%

Survival after cardiac arrest secondary to high-risk pulmonary embolism without reperfusion therapies

Caiyun¹,

Song

Yao

et al. 2019

Medicine

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Introduction: High-risk pulmonary embolism (PE) needs reperfusion therapies. However, it is difficult to make medical decisions when thrombolysis is contraindicated, though pulmonary embolectomy and percutaneous catheter-directed treatment (CTD) are recommended for these patients. Patient concerns: We reported here a case of high-risk PE patient with cardiac arrest (CA), vertebral compression fracture, as well as scalp and frontal hematoma. Diagnosis: The diagnosis of PE was based on computed tomography pulmonary angiography (CTPA) which demonstrated filling defects in the right and left pulmonary arteries. Interventions: Cardiopulmonary resuscitation was performed until the patient returned to idioventricular rhythm 3 minutes after admitted. She suffered another half-hour of hemodynamic disturbance after her shock improved 3 days later. The diagnosis of PE was confirmed by CTPA at that time. The patient did not receive any reperfusion therapies because hemoglobin decreased significantly. Moreover, anticoagulation was postponed for 2 weeks when bleeding appeared to be stopped. She received overlapping treatment with low molecular weight heparin and warfarin for 5 days then warfarin alone and discharged. Outcomes: She was discharged with normal vital signs and neurologically intact. She received anticoagulant therapy with warfarin and international normalized ratio regularly monitored after she was discharged, moreover, the pulmonary artery pressure turned normal, as determined by transthoracic echocardiography 1 month later. The warfarin treatment was discontinued after 12 months and no evidence of recurrence was seen until recently. Conclusions: This is the first case report of PE combined with CA that did not receive reperfusion therapy. We hypothesized that there was a spontaneous resolution in pulmonary emboli.

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