Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
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Surg Obes Relat Dis · Jan 2008
Safety and efficacy of intravascular ultrasound-guided inferior vena cava filter in super obese bariatric patients.
The morbidly obese (body mass index >40 kg/m(2)) are at significant risk of postoperative venous thromboembolism (VTE). Pulmonary embolism is the leading cause of death after Roux-en-Y gastric bypass, approximating .5%. Because of the technical limitations with fluoroscopy and table weight limits, it has been our practice at our university-based bariatric center to offer intravascular ultrasound (IVUS)-guided inferior vena cava filter (IVCF) placement at Roux-en-Y gastric bypass to patients with a history of VTE, hypercoagulable state, or profound immobility. ⋯ These results suggest the efficacy of IVUS-guided IVCF placement in preventing mortality from pulmonary embolism in high-risk bariatric patients. IVUS-guided IVCF placement can be safely performed with an excellent success rate in high-risk patients who would not otherwise be candidates for intervention because of the technical limitations of fluoroscopy.