Risk factors associated with complex inferior vena cava filter retrievals and complications: A 7‐year retrieval database analysis and the impact on retrieval rates at an Australian tertiary centre

Loh, Brendon; Liong, Rebecca; Malacova, Eva; Bain, Roger

doi:10.1111/1754-9485.13305

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…18 In separate observations, we observe floating DVT as indications before implantation of cava filters. [19][20][21][22][23][24] Some studies mention the use of surgical methods of treating floating DVT. [25][26][27] However, evaluating the number of publications on the topic of floating DVT, we can say that this issue is not sufficiently covered today.…”

Section: Discussionmentioning

confidence: 99%

“…According to various authors, coffee filters are used for this. [18][19][20][21][22][23][24] It must be said that we also believe that floating thromboses at high risk of PE, when the length of the floating head remains greater than 5 cm despite conservative therapy, may be indications for implantation of temporary cava filters. In our study, in 6 cases, we implanted temporary cava filters for the prevention of PE during thrombectomy for floating DVT of proximal venous segments, including during aspiration venous thrombectomy.…”

Section: Discussionmentioning

confidence: 99%

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Danger of floating venous thrombosis: myth or reality?

2023

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Introduction To date, the problem of venous thromboembolism and its consequences remains relevant, despite significant progress in the development of phlebology and technologies. Aim In our study, we tried to assess the “danger” of floating DVTs, methods and features of conservative and surgical treatment of patients with floating DVTs, analyze the results of treatment of this group of patients, and draw conclusions based on our data. Materials and methods The results of treatment of 1297 patients with venous thromboembolism for the period 2011–2022 were analyzed. 104 patients were treated with floating deep vein thrombosis, 1193 patients had occlusive proximal venous thrombosis. Results In our study, we determined the danger of floating DVT by comparing the facts of the migration of thrombotic masses in the proximal direction according to the results of treatment in two groups of patients. The first group consisted of 10 patients with proximal floating venous thromboses who were implanted with cava filters, the second group consisted of 28 patients with occlusive proximal venous thrombosis who were implanted with cava filters. Embolism occurred in 40.0% of cases floating DVT, while no cases of embolism were detected in occluding DVT ( p < 0.01). Groups of patients with the length of the floating part of the thrombus up to 5 cm were analyzed. Anticoagulant therapy was used in 42 cases; thrombectomy was performed in 52 cases. There was no case of pulmonary embolism when treated with both conservative and surgical methods. Conclusions Based on our research, it can be stated that floating thrombosis of deep veins of proximal venous segments is a type of thrombosis that has an increased risk of thromboembolic complications when the length of the floating part is 5 cm or more.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Danger of floating venous thrombosis: myth or reality?

2023

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“…Previous studies have highlighted that the rate of IVC filter complications increases in proportion with device dwell time [ 15 , 18 ] and IVC filters are associated with an increased risk of recurrent VTE [ 33 ]. The Food and Drug Administration decision analysis suggests that the benefit of IVC filter removal, compared with leaving devices in situ, commences between 29 and 54 days from filter insertion because of perceived risk of longer dwell times [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Complications may include access site complications (infection or hematoma), filter tilt, filter fracture, caval penetration, embolization/migration, and caval occlusion. Although uncommon, these potential complications can cause morbidity, and the complication risk increases with prolonged filter dwell time [ [15] , [16] , [17] , [18] ]. Concerningly, the majority of IVC filters are not retrieved even after the transient risk factor for VTE has passed or anticoagulation has been commenced [ 14 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Improving the rate of inferior vena cava filter retrieval through multidisciplinary engagement

Stevens

Bortz

Chao

et al. 2023

Research and Practice in Thrombosis and Haemostasis

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“…Лікування флотуючих ТГВ описані лише в окремих працях. Деякі автори визначають флотуючі тромбози як покази до імплантації кава-фільтрів [10][11][12][13][14][15], в інших працях говориться про хірургічні методи лікування флотуючих ТГВ [16][17][18]. Однак звертає на себе увагу той факт, що в жодній з цих публікацій не приводиться чітке визначення флотуючого тромбозу.…”

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A Differentiated Approach in the Treatment of Acute Floating Venous Thrombosis of the Inferior Vena Cava System

Khrebtiy¹

2023

Scientific and practical journal

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We analyzed the results of surgical treatment floating DVT. Unfortunately, there are no randomized studies in the world regarding the determination of clear tactical approaches to the treatment of floating venous thrombosis, in many cases doctors make decisions about the choice of surgical tactics based on their own experience. In our research, we tried to systematize our own experience and form the basic principles of determining surgical tactics in the treatment of floating venous thrombosis. To date, anticoagulants, surgical interventions in the form of thrombectomy, and thrombolytic therapy are used in the treatment of DVT. Unfortunately, at the moment, no consensuses clearly define the issues of surgical treatment of floating venous thrombosis, venous thrombosis in pregnant women, venous thrombosis complicated by pulmonary embolism, venous thromboembolism. The goal. The aim of the research was to develop a surgical tactics in the treatment of floating DVT of the inferior vena cava. Materials and methods. The treatment of 76 patients with floating DVT from 2008 to 2020 were analyzed. In a research among patients with floating DVT in 15(20%) patients experienced thrombosis of the inferior vena cava, 19(25%) patients had ilio-femoral thrombosis in 17(22%) patients with femoral - popliteal thrombosis in 9(12%) patients with popliteal - tibial. Deep vein thrombosis complicated by pulmonary embolism with medium and high risk of death was observed in 10 (13%) patients. Among them, floating thrombosis of the iliac-femoral segment was observed in 4 patients. Floating thrombosis of deep veins in pregnant women was observed in 6 (8%) patients. Among patients, 20 (296%) patients were admitted within 1 day of the onset of the disease, 30 (39%) patients on 2-3 days, 11 (14%) patients on 4-7 days, 8 on 8-14 days (11%) patients, from the 15th day - 7 (10%) patients). The results. Patients with long of floating part of the more than 4 cm, we used an active surgical tactics. In the presence of the floating thrombus a total iliac vein thrombectomy we performed in 12 patients with the removal of the floating thrombus with femoral access. For the prevention of pulmonary embolism in these cases we implanted a temporary cava-filter. When flotation thrombus in the external iliac vein, we used the technique of thrombectomy using Fogarty two catheters in 12 patients. When flotation clots in common femoral vein and distally using a vein thrombectomy with clamping head above floating thrombus. When treating patients with floating DVT, pulmonary embolism complicated with medium and high risk of death, we used systemic thrombolysis with pre- implantation temporary coffee filter in patients with floating DVT, pulmonary embolism complicated with medium and high risk of death, we used systemic thrombolysis with pre- implantation temporary coffee filter. In the presence of pregnancy and floating thrombosis thrombectomy was performed with the removal of the thrombus floating. In our research, when performing the surgical treatment of DVT no cases of pulmonary embolism during or after treatment were observed. In 100 % of patients after treatment has been a clinical improvement in all cases floating DVT was eliminated floating nature of the danger of thrombosis and pulmonary embolism. Conclusions. In the presence of a floating DVT of the inferior vena cava system with a length of the floating part of the thrombus greater than 4 cm, it is necessary to use an active strategy of thrombus removal. When performing thrombectomy, it is necessary to use methods of surgical prevention of PE, taking into account the localization of the floating part.

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Risk factors associated with complex inferior vena cava filter retrievals and complications: A 7‐year retrieval database analysis and the impact on retrieval rates at an Australian tertiary centre

Cited by 5 publications

References 16 publications

Danger of floating venous thrombosis: myth or reality?

Danger of floating venous thrombosis: myth or reality?

Improving the rate of inferior vena cava filter retrieval through multidisciplinary engagement

A Differentiated Approach in the Treatment of Acute Floating Venous Thrombosis of the Inferior Vena Cava System

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