• Bruno Damascelli, Vladimira Ticha, Gianluigi Patelli, Rodolfo Lanocita, Carlo Morosi, Enrico Civelli, Giuseppe Di Tolla, Laura Francesca Frigerio, Elisa Ciceri, Francesco Garbagnati, Carlo Spreafico, Paola Amadeo, and Alfonso Marchianò.
• Department of Radiology and Diagnostic Imaging 2, Istituto Nazionale Tumori, Milan, Italy. bruno.damascelli@fastwebnet.it
• J Vasc Interv Radiol. 2011 Sep 1; 22 (9): 1312-9.

PurposeTo evaluate a retrievable inferior vena cava (IVC) filter in combination with low-intensity oral anticoagulation for prevention of pulmonary embolism (PE) in patients with malignancy complicated by thromboembolic disease.Materials And MethodsFrom October 2005 to December 2009, 107 Bard G2 filters were placed in 106 patients. Forty-eight patients had deep vein thrombosis (DVT) alone, 53 had PE with DVT, and five had PE with no evidence of DVT. After an initial period of anticoagulation with heparin, low-intensity oral anticoagulant therapy to achieve a target International Normalized Ratio of 1.5-2.0 was instituted. Follow-up computed tomography to evaluate the pulmonary circulation, IVC, and lower limbs was performed at 3 and 6 months.ResultsPE recurred in three of 58 patients (5.2%). None of the 48 patients with DVT alone developed PE, nor was there any recurrence of DVT. The filter was removed in 14 patients (13.2%). No complications occurred during the retrieval procedure. A total of 16 complications occurred in seven patients: one migration (0.9%); four cases of vena cava thrombosis (3.7%), three of which were associated with recurrent PE (2.8%); one filter fracture (0.9%); and one IVC penetration (0.9%). Filter tilting greater than 15° occurred in six patients (5.7%) and was associated with other complications in five (4.7%).ConclusionsIn patients with malignancies complicated by venous thromboembolic disease, an IVC filter together with low-intensity anticoagulation may be a possible treatment strategy for PE prophylaxis. Controlled studies are warranted.Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

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