Vena cava filter

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In medicine, vena cava filters, also called Greenfield filters, are "mechanical devices inserted in the inferior vena cava that prevent the migration of blood clots from deep venous thrombosis of the leg."[1]

Inferior vena cava filter reduces pulmonary embolism[2][3] and is an option for patients with an absolute contraindication to anticoagulant treatment (e.g., cerebral hemorrhage) or those rare patients who have objectively documented recurrent pulmonary emboli while on anticoagulation.

A superior vena cava filter can be used for upper extremity thrombosis; however, the median survival is approximately one month.[4][5] A retrievable filter has been used[6]; however, retrievable filters are infrequently retrieved.[7][8]

Clinical practice guidelines address the use of vena cava filters.[9][10]

Adverse effects

Vena cava filters are themselves potential foci of thrombosis.[11] The BARD filter may cause emboli and may fracture.[12]

References

  1. ↑ Anonymous (2024), Vena cava filter (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ Decousus H, Leizorovicz A, Parent F, Page Y, Tardy B, Girard P et al. (1998). "A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prévention du Risque d'Embolie Pulmonaire par Interruption Cave Study Group.". N Engl J Med 338 (7): 409-15. PMID 9459643.
  3. ↑ Young T, Tang H, Aukes J, Hughes R (2007). "Vena caval filters for the prevention of pulmonary embolism.". Cochrane Database Syst Rev (4): CD006212. DOI:10.1002/14651858.CD006212.pub3. PMID 17943896. Research Blogging.
  4. ↑ Usoh F, Hingorani A, Ascher E, et al (September 2008). "Long-term Follow-up for Superior Vena Cava Filter Placement". Ann Vasc Surg. DOI:10.1016/j.avsg.2008.08.012. PMID 18809292. Research Blogging.
  5. ↑ Ascher E, Hingorani A, Tsemekhin B, Yorkovich W, Gunduz Y (November 2000). "Lessons learned from a 6-year clinical experience with superior vena cava Greenfield filters". J. Vasc. Surg. 32 (5): 881–7. DOI:10.1067/mva.2000.110883. PMID 11054219. Research Blogging.
  6. ↑ Nadkarni S, Macdonald S, Cleveland TJ, Gaines PA (2002). "Placement of a retrievable Günther Tulip filter in the superior vena cava for upper extremity deep venous thrombosis". Cardiovasc Intervent Radiol 25 (6): 524–6. DOI:10.1007/s00270-001-0112-9. PMID 12357312. Research Blogging.
  7. ↑ Helling TS, Kaswan S, Miller SL, Tretter JF (2009). "Practice patterns in the use of retrievable inferior vena cava filters in a trauma population: a single-center experience.". J Trauma 67 (6): 1293-6. DOI:10.1097/TA.0b013e3181b0637a. PMID 20009680. Research Blogging.
  8. ↑ Gaspard SF, Gaspard DJ (2009). "Retrievable inferior vena cava filters are rarely removed.". Am Surg 75 (5): 426-8. PMID 19445296.
  9. ↑ Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ et al. (2008). "Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).". Chest 133 (6 Suppl): 454S-545S. DOI:10.1378/chest.08-0658. PMID 18574272. Research Blogging.
  10. ↑ Snow V, Qaseem A, Barry P, Hornbake ER, Rodnick JE, Tobolic T et al. (2007). "Management of venous thromboembolism: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians.". Ann Intern Med 146 (3): 204-10. PMID 17261857.
  11. ↑ (2005) "Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC (Prevention du Risque d'Embolie Pulmonaire par Interruption Cave) randomized study". Circulation 112 (3): 416-22. PMID 16009794.
  12. ↑ Nicholson, William; W. Jay Nicholson, Paul Tolerico, Bradley Taylor, Samuel Solomon, Thomas Schryver, Kevin McCullum, Howard Goldberg, James Mills, Brian Schuler, Larry Shears, Lyle Siddoway, Nikhilesh Agarwal, Christopher Tuohy (2010-08-09). "Prevalence of Fracture and Fragment Embolization of Bard Retrievable Vena Cava Filters and Clinical Implications Including Cardiac Perforation and Tamponade". Arch Intern Med: 2010.316. DOI:10.1001/archinternmed.2010.316. Retrieved on 2010-08-10. Research Blogging.
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