The use of retrievable inferior vena cava filters in orthopaedic patients

J Bone Joint Surg Br. 2008 May;90(5):662-7. doi: 10.1302/0301-620X.90B5.19743.

Abstract

This study was undertaken to evaluate the safety and efficacy of retrievable inferior vena cava filters in high-risk orthopaedic patients. A total of 58 patients had a retrievable inferior vena cava filter placed as an adjunct to chemical and mechanical prophylaxis, most commonly for a history of previous deep-vein thrombosis or pulmonary embolism, polytrauma, or expected prolonged immobilisation. In total 56 patients (96.6%) had an uncomplicated post-operative course. Two patients (3.4%) died in the peri-operative period for unrelated reasons. Of the 56 surviving patients, 50 (89%) were available for follow-up. A total of 32 filters (64%) were removed without complication at a mean of 37.8 days (4 to 238) after placement. There were four filters (8%) which were retained because of thrombosis at the filter site, and four (8%) were retained because of incorporation of the filter into the wall of the inferior vena cava. In ten cases (20%) the retrievable filter was left in place to continue as primary prophylaxis. No patient had post-removal thromboembolic complications. A retrievable inferior vena cava filter, as an adjunct to chemical and mechanical prophylaxis, was a safe and effective means of reducing the acute risk of pulmonary embolism in this high-risk group of patients. Although most filters were removed without complications, thereby avoiding the long-term complications that have plagued permanent indwelling filters, a relatively high percentage of filters had to be left in situ.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Device Removal
  • Female
  • Humans
  • Immobilization / adverse effects
  • Male
  • Middle Aged
  • Orthopedic Procedures / adverse effects
  • Pulmonary Embolism / prevention & control*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Vena Cava Filters / adverse effects*
  • Vena Cava, Inferior
  • Venous Thrombosis / prevention & control*