Temporary vena cava filters in cases of lower limb fractures

Abstract

Objective To evaluate the necessity and safety of implanting temporary vena eava fihers to prevent pulmonary emboli in patients of lower extremity fractures concomitant with acute deep venous thrombosis(DVT). Methods A total of 782 patients with lower extremity fractures were complicated with DVT perioperatively. Among them, 91 received temporary vena cava filters implantation before orthopedic operations for the prevention of pulmonary embolism. All patients were followed up post-operation. Results Vena cava filters were successfully implanted in 89 patients. Mean implantation time was 27 days (range from 14 to 42 days). Thrombus trapped within the filters were found in 78 patients (87.6%) after the filters removal. Eight-two filters (92.1%) were retrived successfully at the first attempt as scheduled. Seven filters(7.9%) with big trapped thrombi were removed at the 2nd attempt after additional thrombolytic therapy. No patients needed a permanent filter. No fetal pulmonary embolism (PE) or other major complications were detected during the three to six months follow-ups period. Conclusion Temporary vena cava filter can reduce the incidence and mortality of pulmonary embolism as well as the occurrence of mid- or long-term complications in lower limb fracture patients complicated with DVT. Key words: Vena cava filters; Fractures, bone; Lower extremity; Pulmonary embolism