TrapEase vena cava filter: Experience in 751 patients

被引:39
|
作者
Kalva, SP
Wicky, S
Waltman, AC
Athanasoulis, CA
机构
[1] Massachusetts Gen Hosp, Dept Radiol, Div Cardiovasc Imaging & Intervent, Boston, MA 02114 USA
[2] Harvard Univ, Sch Med, Boston, MA USA
关键词
venous thromboembolism; inferior vena cava; IVC filters; pulmonary embolism; deep venous thrombosis; complications;
D O I
10.1583/05-1741.1
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose: To evaluate the clinical safety and efficacy of the TrapEase vena Cava filter in a 4-year single-center experience. Methods: The clinical and imaging data of 751 patients (384 men; mean age 64 years, range 16-99) who had a TrapEase inferior vena Cava (IVC) filter placed between January 1, 2001, and December 31, 2004, were reviewed retrospectively. More than a third of patients (297, 39.5%) presented with pulmonary embolism (PE), 188 (25.0%) had deep vein thrombosis (DVT), 40 (5.3%) had both PE and DVT, and the rest (226, 30.1%) had other symptoms. Indications for filter placement were contraindication to anticoagulation (461, 61.4%), complication of anticoagulation (42, 5.6%), failure of anticoagulation (39, 5.2%), and prophylaxis (209, 27.8%). Filters were placed in the infrarenal (n=738) or suprarenal (n=13) position through a femoral (n=729) or jugular vein (n=22) approach. Follow-up computed tomographic (CT) scans of the chest and abdomen were evaluated for recurrent PE and filter-related complications, respectively. Results: Three (0.4%) patients developed groin hematoma. During a mean 295-day clinical follow-up (range 1-1677), 55 (7.5%) patients developed symptoms of PE, and 1 (0.1%) death was attributed to PE. Chest CT performed for various clinical indications in 219 patients at a mean 192 days (range 1-1346) showed PE in 15 (6.8%) patients; 10 were symptomatic and 5 asymptomatic, but there were no fatalities. Follow-up abdominal CT (n=270) at a mean 189 days (range 1-1415) showed fracture of filter components in 8 (3.0%), thrombus within the filter in 68 (25.2%), thrombus extending beyond the filter in 4 (1.5%), near total caval occlusion in 2 (0.7%), and no cases of migration. Conclusion: The TrapEase vena Cava filter is effective in the prevention of pulmonary embolism, with minimal complications.
引用
收藏
页码:365 / 372
页数:8
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