TY - JOUR
T1 - Inferior vena caval filters
T2 - Review of a 26-year single-center clinical experience
AU - Athanasoulis, Christos A.
AU - Kaufman, John A.
AU - Halpern, Elkan F.
AU - Waltman, Arthur C.
AU - Geller, Stuart C.
AU - Fan, Chieh Min
PY - 2000
Y1 - 2000
N2 - PURPOSE: To review a 26-year single-center clinical experience with inferior vena caval filters. MATERIALS AND METHODS: During 1973-1998, 1,765 filters were implanted in 1,731 patients. Hospital files were reviewed, and data were collected about the indications, safety, effectiveness, numbers, and types of caval filters. Fatal postfilter pulmonary embolism (PE) was considered the primary outcome. Morbidity and mortality were determined as secondary outcomes. Survival and morbidity-free survival curves were calculated. RESULTS: The prevalence of observed postfilter PE was 5.6%. It was fatal in 3.7% of patients. In most patients, fatal PE occurred soon after filter insertion (median, 4.0 days; 95% CI: 2.2, 5.8 days). Major complications occurred in 0.3% of procedures. The prevalence of observed postfilter caval thrombosis was 2.7%. The 30-day mortality rate was 17.0% overall, higher among patients with neoplasms (19.5%) as compared with those without neoplasms (14.3%; P = .004). Filter efficacy and associated morbidity were not different in 46 patients with suprarenal filters. The rate of filters placed for prophylaxis was 4.7% overall and increased to 16.4% in 1998. From 1980 to 1996, there was a fivefold increase in the number of caval filter implants. In recent years, more filters were implanted in younger patients. CONCLUSION: Inferior vena caval filters provide protection from life-threatening PE, with minimal morbidity.
AB - PURPOSE: To review a 26-year single-center clinical experience with inferior vena caval filters. MATERIALS AND METHODS: During 1973-1998, 1,765 filters were implanted in 1,731 patients. Hospital files were reviewed, and data were collected about the indications, safety, effectiveness, numbers, and types of caval filters. Fatal postfilter pulmonary embolism (PE) was considered the primary outcome. Morbidity and mortality were determined as secondary outcomes. Survival and morbidity-free survival curves were calculated. RESULTS: The prevalence of observed postfilter PE was 5.6%. It was fatal in 3.7% of patients. In most patients, fatal PE occurred soon after filter insertion (median, 4.0 days; 95% CI: 2.2, 5.8 days). Major complications occurred in 0.3% of procedures. The prevalence of observed postfilter caval thrombosis was 2.7%. The 30-day mortality rate was 17.0% overall, higher among patients with neoplasms (19.5%) as compared with those without neoplasms (14.3%; P = .004). Filter efficacy and associated morbidity were not different in 46 patients with suprarenal filters. The rate of filters placed for prophylaxis was 4.7% overall and increased to 16.4% in 1998. From 1980 to 1996, there was a fivefold increase in the number of caval filter implants. In recent years, more filters were implanted in younger patients. CONCLUSION: Inferior vena caval filters provide protection from life-threatening PE, with minimal morbidity.
KW - Embolism, pulmonary
KW - Interventional procedures, complications
KW - Venae cavae, filters
KW - Venae cavae, interventional procedures
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U2 - 10.1148/radiology.216.1.r00jl1254
DO - 10.1148/radiology.216.1.r00jl1254
M3 - Article
C2 - 10887228
AN - SCOPUS:0033946238
SN - 0033-8419
VL - 216
SP - 54
EP - 66
JO - RADIOLOGY
JF - RADIOLOGY
IS - 1
ER -