Placement of a retrievable inferior vena cava filter for deep venous thrombosis in term pregnancy.

Venous thromboembolism is a significant cause of morbidity and death in pregnant women. Retrievable vena cava filters were placed right before labor as prophylaxis for peripartum pulmonary embolism. We reviewed the experience of caval filter placement and retrieval in term pregnancy in this study. We reviewed 15 patients with deep venous thrombosis (DVT) of the lower extremity who underwent OptEase (Cordis Corp, New Brunswick, NJ) retrievable vena cava filter placement. DVT was diagnosed by clinical symptoms and Doppler ultrasound imaging. Subcutaneous low-molecular-weight heparin was eased 12 hours before cesarean delivery and restarted 12 hours after delivery. The caval filters were placed suprarenally from the jugular approach and retrieved from the femoral approach. The filters were successfully placed in all patients on the day of cesarean delivery. No placement-related complications occurred. The caval filter was left in situ as a permanent device in one patient because the captured thrombus within the filter was not eliminated after the thrombolytic therapy. Filters in other 14 patients were retrieved successfully, without difficulty, including in one patient after complete lysis of captured thrombus by the thrombolytic therapy. Oral warfarin therapy was recommended for at least 3 months after hospital discharge, and for at least 6 months in the patient with a caval filter left in situ. All patients were examined by Doppler ultrasound imaging during the follow-up. None presented with symptomatic pulmonary embolism or filter-related complications. OptEase retrievable vena cava filter placement and retrieval in term pregnant patients with extensive DVT of the lower extremities is safe, effective, and feasible. The results in our study may justify prophylactic filter placement use right before labor.

Liu Y ，Sun Y ，Zhang S ，Jin X ... -  《-》

Role of prophylactic temporary inferior vena cava filters placed at the ICU bedside under intravascular ultrasound guidance in patients with multiple trauma.

Rosenthal D ，Wellons ED ，Levitt AB ，Shuler FW ，O'Conner RE ，Henderson VJ ... -  《-》

Efficacy of Retrievable Inferior Vena Cava Filter Placement in the Prevention of Pulmonary Embolism during Catheter-Directed Thrombectomy for Proximal Lower-Extremity Deep Vein Thrombosis.

Inferior vena cava (IVC) filter placement is not indicated for thrombolytic interventional treatment for deep vein thrombosis (DVT). We analyzed the efficacy and feasibility of retrievable IVC filter placement for the preventive management of embolic shedding during catheter-directed thrombectomy (CDT) for DVT of lower extremity. Seventy patients (35 males and 35 females) who underwent retrievable IVC filter placement to prevent thrombus dislodgement during CDT in all symptomatic DVT with thrombus age suspected within 4 weeks of the lower extremity between March 2008 and January 2014 were included in this study. All patients underwent laboratory blood study, duplex ultrasound and/or computed tomography for diagnosis, treatment, and follow-up in accordance with treatment policy of our Uijeongbu St. Mary's hospital. Two types of retrievable IVC filters (OptEase Filter, Cordis, Roden, The Netherlands; Gunther Tulip Filter, Cook, Bloomington, IN) were used to prevent thromboembolic events during CDT. After filter placement, subcutaneous low-molecular-weight heparin and overlapped to warfarin or new oral anticoagulant tried to achieve a target international normalized ratio (INR) of 2.0-3.0 in warfarin patients. The thrombus was dislodged through the IVC filter during catheter-directed thrombolytic therapy in 22 patients (31.4%). In 22 cases, the thromboses were trapped by the retrievable IVC filter, and follow-up images showed thrombus capture. Thirty-four patients (48.6%) received percutaneous transluminal angioplasty (PTA). Additional stents were inserted in 23 patients (32.8%). Pulmonary embolism (PE) was not observed in patients implanted with retrievable IVC filters. Our study findings suggest that retrieval IVC filter placement during interventional treatments of DVT of lower extremity such as thrombectomy of vein thrombus with or without stent insertion at compressed deep vein is favorable and effective for protecting against PE or lethal complications. We recommend carefully that before the management of DVT thrombus of lower extremity, retrieval IVC filter placement should be considered for preventing morbidity related with the PE.

Lee SH ，Kim HK ，Hwang JK ，Kim SD ，Park SC ，Kim JI ，Won YS ，Youn SS ，Moon IS ... -  《-》

The Jonas study: evaluation of the retrievability of the Cordis OptEase inferior vena cava filter.

Oliva VL ，Szatmari F ，Giroux MF ，Flemming BK ，Cohen SA ，Soulez G ... -  《JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY》

Retrievable inferior vena cava filters: early clinical experience.

Rosenthal D ，Wellons ED ，Lai KM ，Bikk A ... -  《-》