Inferior vena cava filters and postoperative outcomes in patients undergoing bariatric surgery: a meta-analysis

Kaw, Roop; Pasupuleti, Vinay; Overby, D. Wayne; Deshpande, Abhishek; Coleman, Craig I.; Ioannidis, John P. A.; Hernandez, Adrián V.

doi:10.1016/j.soard.2014.04.008

Cited by 44 publications

(23 citation statements)

References 18 publications

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“…Summary of the evidence. We identified 2 systematic reviews of RCTs and observational studies 137,138 that addressed this research question in bariatric surgery and trauma patients. We identified 14 studies [139][140][141][142][143][144][145][146][147][148][149][150][151][152] in these reviews that fulfilled our inclusion criteria and measured outcomes relevant to this context.…”

Section: Recommendationmentioning

confidence: 99%

American Society of Hematology 2019 guidelines for management of venous thromboembolism: prevention of venous thromboembolism in surgical hospitalized patients

et al. 2019

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Background:Venous thromboembolism (VTE) is a common source of perioperative morbidity and mortality.Objective:These evidence-based guidelines from the American Society of Hematology (ASH) intend to support decision making about preventing VTE in patients undergoing surgery.Methods:ASH formed a multidisciplinary guideline panel balanced to minimize bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline-development process, including performing systematic reviews. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment.Results:The panel agreed on 30 recommendations, including for major surgery in general (n = 8), orthopedic surgery (n = 7), major general surgery (n = 3), major neurosurgical procedures (n = 2), urological surgery (n = 4), cardiac surgery and major vascular surgery (n = 2), major trauma (n = 2), and major gynecological surgery (n = 2).Conclusions:For patients undergoing major surgery in general, the panel made conditional recommendations for mechanical prophylaxis over no prophylaxis, for pneumatic compression prophylaxis over graduated compression stockings, and against inferior vena cava filters. In patients undergoing total hip or total knee arthroplasty, conditional recommendations included using either aspirin or anticoagulants, as well as for a direct oral anticoagulant over low-molecular-weight heparin (LMWH). For major general surgery, the panel suggested pharmacological prophylaxis over no prophylaxis, using LMWH or unfractionated heparin. For major neurosurgery, transurethral resection of the prostate, or radical prostatectomy, the panel suggested against pharmacological prophylaxis. For major trauma surgery or major gynecological surgery, the panel suggested pharmacological prophylaxis over no prophylaxis.

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Section: Recommendationmentioning

confidence: 99%

American Society of Hematology 2019 guidelines for management of venous thromboembolism: prevention of venous thromboembolism in surgical hospitalized patients

et al. 2019

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“…Meta-analysis of six observational studies suggested higher risk of deep venous thrombosis (OR 2.81, 95% CI 1.33 to 5.97), similar risk of pulmonary embolism (RR 1.02, 95% CI 0.31 to 3.37) and a trend towards higher risk of mortality with inferior vena cava filters (RR 3.27, 95% CI 0.78 to 13.64), albeit with wide interval estimates ( Supplementary Table S9) [64]. Due to the importance of these outcomes and despite the low certainty of the evidence overall, this difference in effect estimates prompted the panel to provide a strong recommendation against the use of filters outside a research protocol.…”

Section: Strong Recommendationmentioning

confidence: 99%

Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP

et al. 2020

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Background Surgery for obesity and metabolic diseases has been evolved in the light of new scientific evidence, long-term outcomes and accumulated experience. EAES has sponsored an update of previous guidelines on bariatric surgery. Methods A multidisciplinary group of bariatric surgeons, obesity physicians, nutritional experts, psychologists, anesthetists and a patient representative comprised the guideline development panel. Development and reporting conformed to GRADE guidelines and AGREE II standards. Results Systematic review of databases, record selection, data extraction and synthesis, evidence appraisal and evidence-todecision frameworks were developed for 42 key questions in the domains Indication; Preoperative work-up; Perioperative management; Non-bypass, bypass and one-anastomosis procedures; Revisional surgery; Postoperative care; and Investigational procedures. A total of 36 recommendations and position statements were formed through a modified Delphi procedure. and Other Interventional Techniques Disclaimer This clinical practice guideline has been developed under the auspice of the European Association for Endoscopic Surgery (EAES). It is intended to be used primarily by health professionals (e.g. surgeons, anesthetists, physicians) and to assist in making informed clinical decisions on diagnostic measures and therapeutic management. It is also intended to inform individual practice of allied health professionals (e.g. surgical nurses, dietitians, physical rehabilitation therapists, psychologists); to inform strategic planning and resource management by healthcare authorities (e.g. regional and national authorities, healthcare institutions, hospital administration authorities); and to inform patients wishing to obtain an overview of the condition of interest and its management. The use of recommendations contained herein must be informed by supporting evidence accompanying each recommendation and by research evidence that might not have been published by the time of writing the present document. Users must thus base their actions informed by newly published evidence at any given point Electronic supplementary material The online version of this article (

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“…Two papers were published recently in an attempt to address this issue. One was a meta-analysis that examined 6 papers culled from 701 abstracts [41]. The papers analyzed were a mix of prospective and retrospective cohorts and involved mostly open bariatric surgery.…”

Section: Research In Indicationsmentioning

confidence: 99%

“…Patients identified as highest risk included those with prior VTE, pulmonary hypertension, a personal or family history of coagulopathy, chronic immobility, preoperative lower extremity venous stasis, and those with the Bhighest^BMI. However, as with the meta-analysis by Kaw [41], a specific BMI value could not be provided due to the lack of uniformity of definitions used in the papers that were analyzed .…”

Section: Research In Indicationsmentioning

confidence: 99%

Inferior Vena Cava Filters: Indications, Outcomes, and Evidence

Montgomery

Kaufman

2015

Curr Treat Options Cardio Med

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Filter technology seems relatively stable, although absorbable devices are an area of investigational interest. The indications for filter placement remain controversial, with wide variations in adherence to guidelines, and relatively poor quality of data about the specific prophylactic indications of trauma or bariatric surgery. The outcomes of filters are not well-defined despite widespread clinical use, and good data remains difficult to obtain. Several larger database and institutional retrospective studies support the notions that while filters prevent pulmonary embolism, they may be associated with venous thrombotic complications. Some subsets of cancer patients may be at increased risk of these complications, but whether the filter or the underlying hypercoagulable state is the cause is not clear. Lastly, although the benefits of filter retrieval are widely assumed (but not proven), filter retrieval rates remain lower than expected. The single most influential factor in improving filter retrieval rates is dedicated follow-up with intent to retrieve the filter.

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Inferior vena cava filters and postoperative outcomes in patients undergoing bariatric surgery: a meta-analysis

Cited by 44 publications

References 18 publications

American Society of Hematology 2019 guidelines for management of venous thromboembolism: prevention of venous thromboembolism in surgical hospitalized patients

American Society of Hematology 2019 guidelines for management of venous thromboembolism: prevention of venous thromboembolism in surgical hospitalized patients

Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP

Inferior Vena Cava Filters: Indications, Outcomes, and Evidence

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