Clinical follow-up of patients with percutaneously inserted inferior vena caval filters.

Abstract

This is a retrospective clinical follow-up study of 45 consecutive patients who had percutaneous placement of inferior venal caval (IVC) filters in the period 1987 to 1993 to prevent mortality, or severe morbidity, from pulmonary embolism (PE). Ten patients had Gunther filters (GF) and 35 had bird's nest filters (BNF) from 1989. Clinical indications for filter placement were: 23 patients with anticoagulation contraindications, six with anticoagulation failure and recurrent PE, 10 with anticoagulation complications, two with critical PE and four with leg thrombi and PE. Two patients died from recurrent PE after filter placement, one with a GF migrating after replacement, and one with a BNF. Two patients died from severe PE, occurring prior to filter placement. Fifteen patients died in the study period, none due to recurrent PE. Twenty-five patients remain alive, with a mean follow-up period of 21 months, with none having recurring PE. One patient was lost to clinical follow-up. One patient suffered technical difficulty in BNF placement, and underwent surgical removal of a hook penetrating an iliac vein wall. Inferior vena cava filters are efficacious in preventing potentially fatal pulmonary embolism, in both the acute period and the medium term. There are low rates of morbidity associated with their use.