• J Trauma · Apr 2010

    Inferior vena cava filters in trauma patients: efficacy, morbidity, and retrievability.

    • Rory L Smoot, Cody A Koch, Stephanie F Heller, Enrique A Sabater, Daniel C Cullinane, Michael P Bannon, Kristine M Thomsen, William S Harmsen, Yvonne Baerga-Varela, and Henry J Schiller.
    • Division of Trauma, Critical Care, and General Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
    • J Trauma. 2010 Apr 1; 68 (4): 899-903.

    BackgroundThromboembolic events are potentially devastating sources of morbidity in trauma patients. With increasing experience and the introduction of retrievable devices, there has been a renewed interest in inferior vena cava (IVC) filters in trauma patients.MethodsThe records for consecutive trauma patients undergoing IVC filter placement during the years 2001 to 2005 were reviewed, and clinical, demographic, and procedural data were evaluated for associations with thromboembolic events and device complications.ResultsDuring the study years, 226 trauma patients had IVC filters inserted, and 140 of these patients (62%) had retrievable IVC filters placed. Six patients (3%) had a pulmonary embolism with the filter in place, and two patients (1%) had a pulmonary embolism after filter removal. The most common complication was thrombosis in 27 patients (12%), with clinically significant thrombus occurring in 15 patients (7%). There was no association between the type of filter (permanent or retrievable) or the brand of retrievable filter and thrombosis. Specific risk factors for thrombosis could not be identified. Retrievable filters were successfully removed in 61% of patients with retrievable filters. Technical success rate was 97% in those patients who underwent attempted removal. Removal was completed at a median of 21 days (range, 2-292 days).ConclusionsRetrievable IVC filters in trauma patients are safe, but complications do occur with thrombosis being the most common. Retrieval has a high technical success rate when attempted. However, a significant number of trauma patients are lost to follow-up and this may impact the utilization of retrievable filters in this patient population.

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