Prophylactic Vena Cava Filter Insertion in Selected High-Risk Orthopaedic Trauma Patients

Rogers, Frederick B.; Shackford, Steven R.; Ricci, Michael A.; Huber, Bryan; Atkins, Thomas

doi:10.1097/00005131-199705000-00006

Cited by 43 publications

(23 citation statements)

References 24 publications

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“…Most studies used duplex ultrasonography for DVT diagnosis, although some older studies used outdated modalities, such as impedance plethysmography. 26,27 For the diagnosis of PE, most studies used computed tomographic angiography, but some used conventional angiography or, infrequently, ventilation/perfusion scans. We excluded 2 studies 26,29 from the pooled analyses because we considered them to have substantial flaws.…”

Section: Study Characteristicsmentioning

confidence: 99%

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The Effectiveness of Prophylactic Inferior Vena Cava Filters in Trauma Patients

et al. 2014

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Section: Study Characteristicsmentioning

confidence: 99%

“…The first study had severe prognostic imbalance in Injury Severity Scores (ISSs) between study groups (mean ISS, 22.8 vs 9.8, filter vs control). 26 The second study was excluded because of concerns about overlapping participants with another study by the same authors from the same institution and the same study period. 29 …”

Section: Study Characteristicsmentioning

confidence: 99%

The Effectiveness of Prophylactic Inferior Vena Cava Filters in Trauma Patients

et al. 2014

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“…All seven were cohort studies that reported PE rates, two of which also report DVT outcomes [7,18]. Three studies were prospective studies [5,15,16] and four were retrospective studies [7,9,17,18]. Five studies were conducted at Level 1 trauma Gosin et al [15] 1997 Observational cohort 7…”

Section: Characteristics Of Studies Includedmentioning

confidence: 99%

“…In contrast, the 2008 American College of Chest Physicians (ACCP) guidelines on the prevention of VTE recommended against the use of IVCF as primary prophylaxis in trauma patients based on Grade IC evidence (strong evidence based on observational studies) [3]. The literature on the efficacy of pIVCFs in trauma patients without VTE is controversial [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. To date, there have been no randomized controlled trials addressing the efficacy of IVCFs as VTE prophylaxis in any patient population.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary embolism prophylaxis with inferior vena cava filters in trauma patients: a systematic review using the meta-analysis of observational studies in epidemiology (MOOSE) guidelines

Rajasekhar

Lottenberg

et al. 2011

J Thromb Thrombolysis

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Prophylactic inferior vena cava filters (pIVCFs) for the prevention of pulmonary embolism (PE) are controversial. Current practice guidelines (EAST and ACCP) are based on the critical appraisal of observational studies. As a result, their recommendations are conflicting and may account for practice pattern variation. The purpose of this study is to critically review the available literature and ascertain the level of evidence both for and against the use of pIVCFs for PE prophylaxis in trauma patients. We searched PubMed and Web of Science for publications from 1950 until July 2010 that assessed the efficacy of PE prevention with pIVCFs in the trauma population. We followed the MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines for design, implementation, and reporting. The Newcastle-Ottawa Score was used for quality and comparability assessment. Seven observational studies met inclusion criteria for this meta-analysis, representing 1,900 patients. Only one study was published in this decade. The rate of PE was statistically lower in the IVCF group compared to a matched control group without IVCFs (OR 0.21, 95% CI 0.09-0.49). There was no significant difference in DVT. Using the MOOSE criteria these results show a decreased likelihood of PE among trauma patients who receive pIVCFs. Although these results could favor the placement of pIVCFs, the lack of contemporary use of pharmacologic prophylaxis across studies does not allow us to make firm conclusions either for or against the routine use of pIVCFs. Prospective randomized trials are needed to determine the role of pIVCFs in high-risk trauma patients.

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“…Foram relatados, além dos aspectos comentados, trombose da veia de acesso ao implante em cerca de 20% dos casos 6 , implantação errô-nea em veia ilíaca, renal ou aurícula direita 7,8 , migração para a aurícula direita 9 , fratura das hastes 10 , extrusão das hastes 11 com perfuração de vísceras 12 e inclinação do filtro em relação ao eixo da veia cava 13 .…”

Section: Introductionunclassified

Experiência preliminar com novo filtro de veia cava: resultados de 15 implantes

et al. 2008

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ResumoEste estudo apresenta resultados preliminares obtidos com um novo filtro permanente de veia cava, baseado no desenho de Greenfield, com três hastes prolongadas de um total de seis, para dar estabilidade central ao filtro na luz da veia cava. Neste artigo, relatamos sua avaliação clínica preliminar quanto à aplicabilidade, eficácia e segurança. De agosto de 2004 a dezembro de 2006, 15 filtros foram implantados em nove homens e seis mulheres, com idades variando de 38 a 79 anos (média de 57,8 anos). O acesso foi feito sempre por via transjugular. As indicações foram: trombose venosa proximal, com contra-indicação de anticoagulação em 12 pacientes; complicações hemorrágicas com anticoagulação em dois pacientes; e embolia pulmonar, apesar de anticoagulação adequada, em um paciente. Os filtros foram avaliados quanto à liberação, inclinação, mau posicionamento e perfuração de cava. No seguimento, avaliou-se trombose no local de acesso, tromboembolismo venoso recorrente, migração do filtro e trombose de cava pelo ultra-som. Nenhum paciente recebeu anticoagulantes no seguimento. O filtro foi liberado com sucesso em todos os casos sem mau posicionamento, inclinação, perfuração ou trombose de acesso. Os pacientes foram seguidos entre 3 e 23 meses (média de 11 meses). Nenhum paciente teve recorrência de tromboembolismo venoso. Não houve casos de trombose de veia cava ou migração do filtro. Óbito ocorreu em sete casos, todos relacionados com a moléstia de base. Os resultados preliminares indicam potencial eficácia e segurança do uso do novo filtro no período estudado.Palavras-chave: Filtro de veia cava, desenho de próteses, embolia pulmonar/prevenção, controle, trombose venosa. AbstractThis study presents preliminary results obtained from a new permanent filter, based on Greenfield's filter design, with prolongations on three of six struts to stabilize it centrally in the vena caval lumen. The preliminary clinical evaluation of the filter with regard to feasibility, efficacy and safety is reported. From August 2004 to December 2006, 15 vena cava filters were deployed in nine men and six women, who ranged in age from 38 to 79 years (mean, 57.8 years). The approach used was always transjugular. Indications for filter placement were proximal deep venous thrombosis with a contraindication to anticoagulation in 12 patients; hemorrhagic complications with anticoagulation in two patients; and pulmonary embolism, despite adequate anticoagulation in one patient. New vena cava filters were evaluated for releasing, tilting, malpositioning and caval perforation. Follow-up included assessment of access site thrombosis and filter migration, recurrent venous thromboembolism, and caval thrombosis by duplex ultrasound. No patient received anticoagulants in the follow-up. In all patients the filter was successfully released, with no malpositioning, tilting, perforation or access thrombosis. The patients were followed for 3 to 23 months (mean = 11 months). No patient developed recurrent venous thromboembolism. No other patients develope...

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Prophylactic Vena Cava Filter Insertion in Selected High-Risk Orthopaedic Trauma Patients

Cited by 43 publications

References 24 publications

The Effectiveness of Prophylactic Inferior Vena Cava Filters in Trauma Patients

The Effectiveness of Prophylactic Inferior Vena Cava Filters in Trauma Patients

Pulmonary embolism prophylaxis with inferior vena cava filters in trauma patients: a systematic review using the meta-analysis of observational studies in epidemiology (MOOSE) guidelines

Experiência preliminar com novo filtro de veia cava: resultados de 15 implantes

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