Permanent inferior vena cava filter in the treatment of deep vein thrombosis of lower limb: mid-term and long-term outcome and the clinical significance

Abstract

Objective To assess the mid-term and long-term efficacy of the permanent inferior vena cava filter in the treatment of deep vein thrombosis of lower limb and discuss the clinical significance of inferior vena cava filter. Methods Retrospectively analyze on the 86 cases with deep vein thrombosis of lower limb (41 males and 45 females, aged 50 to 94 years, mean age was 71.8 years) treated with implantation of permanent inferior vena cava filter in inferior vena cava from Janunary 2010 to October 2015.In these patients, there were 51 cases with embolism in the left leg, 25 cases in the right leg, 10 cases in both legs and 6 cases were accompanied with pulmonary embolism. The cases without contraindication underwent catheter directed thrombolysis and even percutaneous transluminal angioplasty or stents subsequently if necessary after inferior vena cava filter implantation. All the cases with no contraindication were treated with anticoagulant therapy. Results All the 86 patients were implanted inferior vena cava filter (B.Braun Vena Tech LP 76 and Cordis TrapEase 10)successfully. Sisty-five cases were underwent inferior vena cava filter implantation only, while 21 cases were treated with inferior vena cava filter implantation and catheter directed thrombolysis or even percutaneous transluminal angioplasty and stents. During the follow-up period(12 to 81 months, mean time was 51 months), 27 patients died dueing to malignant tumor(17 cases) and other diseases(10 cases) rather than complications caused by inferior vena cava filter. Three patients had recurrence of deep vein thrombosis and 2 patients suffered from the thrombosis induced by stenosis of stents. Inferior vena cava filter appered tilted with angle less than 15 degrees in 6 cases. Three cases suffered from new thrombosis below the filter and 2 cases complained of the filter migration. No case was found with fracture of filter, perforation of the inferior vena cava, bleeding or pulmonary embolism(new onset or recurrent). Conclusions Application of permanent inferior vena cava filter may cause complications, though it is an effective approach to prevent pulmonary embolism in patients with deep vein thrombosis of lower limb. However, permanent inferior vena cava filter may be fit for patients with old age, incurable cancer or limited expected life. Key words: Thrombosis, deep vein; Vena cava filters; Pulmonary embolism; Treatment outcome