Interruption of the inferior vena cava using the Vascor filter: preliminary series of 51 cases.

Abstract

Between February 1991 and October 1991, vena cava filters made of Vascor (Toulon, France) were inserted into 51 patients. The male:female ratio was 29:22 and mean age 74 (range 45-94) years. Diagnosis of thrombophlebitis was established by venography in 48 patients (94%) and ultrasonography in three (6%). Thrombosis was unilateral in 49 patients and bilateral in two, involved the pelvic veins in 38 (75%) and the leg veins in 13 (25%). Of the 51 patients, 17 (33%) presented pulmonary emboli and 12 (24%) had waving supracrural clots. The Vascor umbrella filter is a two-stage stainless-steel device with attachment tabs for anchoring and centering. It can be placed either percutaneously using a 7-gauge French introducer via the jugular, subclavian or brachial vein or surgically. In the present series, placement was achieved percutaneously via the jugular vein, in 49 cases (96%) and surgically in two (4%). Postoperative and follow-up examinations included coagulation tests, Doppler ultrasonography and abdominal radiography. In the immediate postoperative period, one patient developed a pneumothorax which was treated by pleural drainage and five died from cancer within the first month after placement. There were no postoperative accidents and no patient had recurrent embolism. In three patients, the filter tilted 30 degrees and in one caval thrombosis was identified. Follow-up examinations were performed in 46 patients, with a mean duration of 12 months. Ten patients have died. Caval thrombosis occurred in two patients (4%) but proximal migration of the filter and recurrence of pulmonary embolism have not been observed.