Vena Cava Filters in Cancer Patients: Experience With 50 Patients

Abstract

OBJECTIVE:To study the immediate and late results obtained from the implantation of vena cava filters in cancer patients with deep vein thrombosis concomitant with neoplasia. METHODS: This was a retrospective evaluation of 50 patients with an association of cancer and deep venous thrombosis who underwent interruption of the inferior vena cava and the insertion of permanent vena cava filters. The indications for the procedure, filter implantation technique, early and late complications related to the operation, and the clinical evolution were evaluated. RESULTS: The most frequent indication for filter implantation was the contraindication for full anticoagulant treatment (80%). The femoral vein was the preferred access route (86% of the patients). There were no complications related to the surgical procedure. During the follow-up, the following complications were observed: 1 episode of nonfatal pulmonary thromboembolism, 2 cases of occlusion of the inferior vena cava, and 1 case of thrombus retained in the device. Twenty patients (40%) died due to progression of the neoplasm. CONCLUSIONS: Interruption of the inferior cava vein using an endoluminal filter is a procedure with a low rate of complications. It is a safe and efficient measure for preventing pulmonary embolism in cancer patients who have deep vein thrombosis of the lower limbs.

Impact of Endovascular Technique in Vascular Surgery Training at a Large University Hospital in Brazil

“…Improvements in surgical devices and radiologic equipment 11 quickly made endovascular surgical approaches an acceptable alternative in the treatment of other vascular segments and diseases. [10][11][12] Aneurysms, dissections, and stenosis of the aorta and its branches are now, in most cases, treated using endovascular techniques, provided the disease is within some anatomic guidelines. From an option reserved for patients in 16 Moreover, the increase achieved in the endovascular operations offset this loss.…”

2008 french national guidelines for the treatment of venous thromboembolism in patients with cancer: Report from the working group

“…In the sole published randomized clinical trial that studied the benefit [60]. We identified ten retrospective cohort studies, including eight non-comparative studies and two studies comparing the efficacy of vena cava filters versus heparin followed by VKA [41][42][43][44][45][46][47][48][49][50] (Table 7). The size of the study populations varied between 29 and 308 patients.…”

Management of cancer-associated thrombosis in people with advanced disease

“…There is no evidence that insertion of a vena caval filter improves outcome for cancer patients with VTE who are bleeding and published studies are too small for useful conclusions 40–45. The evidence in the advanced cancer population is even weaker and given inferior vena cava (IVC) filters do not reduce symptoms of VTE or improve survival, the use of these devices are limited in the palliative setting.…”