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Erschienen in: Annals of Vascular Surgery 3/2005

01.05.2005 | Selected Techniques

The Prophylactic Use of Inferior Vena Cava Filters in Patients Undergoing High-Risk Spinal Surgery

verfasst von: Luis Leon, MD, Heron Rodriguez, MD, Rabih G. Tawk, MD, Stephen L. Ondra, MD, Nicos Labropoulos, PhD, Mark D. Morasch, MD

Erschienen in: Annals of Vascular Surgery | Ausgabe 3/2005

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Abstract

Prophylactic inferior vena cava filter (IVCF) placement is advocated in some high-risk groups. We sought data regarding safety and efficacy for prophylactic IVCF placement in patients at high risk for venous thromboembolism (VTE) following major spinal reconstruction. Seventy-four spine surgery patients with contraindication to anticoagulation (44 females, 30 males; mean age 56.2) received prophylactic IVCFs. Criteria were (1) history of thromboembolism, (2) diagnosed thrombophilia, (3) malignancy, (4) bedridden >2 weeks prior to surgery, (5) staged procedures or multiple levels, (6) combined anterior/posterior approaches, (7) expected need for significant iliocaval manipulation during exposure, and (8) single-stage anesthetic time >8 hr. Seventy patients had at least two risk factors. All received IVCFs prior to the first stage of spine reconstruction. Patients were evaluated for filter complications, deep vein thrombosis (DVT), and pulmonary embolism (PE). Patients’ lower extremity veins from groin to ankle were imaged weekly until discharge using duplex ultrasound (DUS). One-third also underwent thoracic and pelvic computed tomography scans, and the pelvic veins, IVC, and pulmonary vasculature were evaluated for VTE. Multiple DUS (n = 198, mean 2.6 studies per patient) were performed in 68 patients. At a mean follow-up of 11 months, one of the patients developed PE. Twenty-seven limbs in 23 patients developed DVT. Five limbs had isolated calf DVT, and 22 had proximal vein involvement. Insertion site DVT accounted for nearly one-third of the DVTs. Six patients died from unrelated complications. There was one technical error with an IVCF deployed in the iliac vein. Despite a high incidence of DVT following high-risk spinal surgery, prophylactic IVCF placement appears to protect patients from PE.
Literatur
1.
Zurück zum Zitat Anderson, FA,Jr, Wheeler, HB, Goldberg, RJ, et al. 1991A population based perspective of the hospital incidence and case fatality rates of deep vein thrombosis and pulmonary embolism: the Worcester DVT StudyArch Intern Med151933938CrossRefPubMed Anderson, FA,Jr, Wheeler, HB, Goldberg, RJ,  et al. 1991A population based perspective of the hospital incidence and case fatality rates of deep vein thrombosis and pulmonary embolism: the Worcester DVT StudyArch Intern Med151933938CrossRefPubMed
2.
Zurück zum Zitat Kaboli, P, Henderson, MC, White, RH 2003DVT prophylaxis and anticoagulation in the surgical patientMed Clin North Am8777110CrossRefPubMed Kaboli, P, Henderson, MC, White, RH 2003DVT prophylaxis and anticoagulation in the surgical patientMed Clin North Am8777110CrossRefPubMed
3.
Zurück zum Zitat Bergqvist, D 1994The role of vena caval interruption in patients with venous thromboembolismProg Cardiovasc Dis372537PubMed Bergqvist, D 1994The role of vena caval interruption in patients with venous thromboembolismProg Cardiovasc Dis372537PubMed
4.
Zurück zum Zitat White, RH, Zhou, H, Kim, J, et al. 2000A population-based study of the effectiveness of inferior vena cava filter use among patients with venous thromboembolismArch Intern Med16020332041CrossRefPubMed White, RH, Zhou, H, Kim, J,  et al. 2000A population-based study of the effectiveness of inferior vena cava filter use among patients with venous thromboembolismArch Intern Med16020332041CrossRefPubMed
5.
Zurück zum Zitat Rogers, FB, Shackford, SR, Ricci, MA, et al. 1995Routine prophylactic vena cava filter insertion in severely injured trauma patients decreases the incidence of pulmonary embolismJ Am Coll Surg180641647PubMed Rogers, FB, Shackford, SR, Ricci, MA,  et al. 1995Routine prophylactic vena cava filter insertion in severely injured trauma patients decreases the incidence of pulmonary embolismJ Am Coll Surg180641647PubMed
6.
Zurück zum Zitat Velmahos, GC, Kern, J, Chan, LS, et al. 2000Prevention of venous thromboembolism after injury: an evidence-based report; part I. Analysis of risk factors and evaluation of the role of vena caval filtersJ Trauma49132138PubMed Velmahos, GC, Kern, J, Chan, LS,  et al. 2000Prevention of venous thromboembolism after injury: an evidence-based report; part I. Analysis of risk factors and evaluation of the role of vena caval filtersJ Trauma49132138PubMed
7.
Zurück zum Zitat Velmahos, GC, Kern, J, Chan, LS, et al. 2000Prevention of venous thromboembolism after injury: an evidence-based report; part II. Analysis of risk factors and evaluation of the role of vena caval filtersJ Trauma49140144PubMed Velmahos, GC, Kern, J, Chan, LS,  et al. 2000Prevention of venous thromboembolism after injury: an evidence-based report; part II. Analysis of risk factors and evaluation of the role of vena caval filtersJ Trauma49140144PubMed
8.
Zurück zum Zitat Gosin, JS, Graham, AM, Ciocca, RG, Hammond, JS 1997Efficacy of prophylactic vena cava filters in high-risk trauma patientsAnn Vasc Surg11100105PubMed Gosin, JS, Graham, AM, Ciocca, RG, Hammond, JS 1997Efficacy of prophylactic vena cava filters in high-risk trauma patientsAnn Vasc Surg11100105PubMed
9.
Zurück zum Zitat Maxwell, RA, Chavarria-Aguilar, M, Cockerham, WT, et al. 2002Routine prophylactic vena cava filtration is not indicated after acute spinal cord injuryJ Trauma52902906PubMed Maxwell, RA, Chavarria-Aguilar, M, Cockerham, WT,  et al. 2002Routine prophylactic vena cava filtration is not indicated after acute spinal cord injuryJ Trauma52902906PubMed
10.
Zurück zum Zitat Carlin, AM, Tyburski, JG, Wilson, RF, Steffes, C 2002Prophylactic and therapeutic inferior vena cava filters to prevent pulmonary emboli in trauma patientsArch Surg 137521527PubMed Carlin, AM, Tyburski, JG, Wilson, RF, Steffes, C 2002Prophylactic and therapeutic inferior vena cava filters to prevent pulmonary emboli in trauma patientsArch Surg 137521527PubMed
11.
Zurück zum Zitat Dearborn, JT, Hu, SS, Tribus, CB, Bradford, DS 1999Thromboembolic complications after major thoracolumbar spine surgerySpine2414711476PubMed Dearborn, JT, Hu, SS, Tribus, CB, Bradford, DS 1999Thromboembolic complications after major thoracolumbar spine surgerySpine2414711476PubMed
12.
Zurück zum Zitat Calligaro, KD, Bergan, WS, Haut, MJ, et al. 1991Thromboembolic complications in patients with advanced cancer: anticoagulation versus Greenfield filter placementAnn Vasc Surg5186189PubMed Calligaro, KD, Bergan, WS, Haut, MJ,  et al. 1991Thromboembolic complications in patients with advanced cancer: anticoagulation versus Greenfield filter placementAnn Vasc Surg5186189PubMed
13.
Zurück zum Zitat Cohen, JR, Tenenbaum, N, Citron, M 1991Greenfield filter as primary therapy for deep venous thrombosis and/or pulmonary embolism in patients with cancerSurgery1091215PubMed Cohen, JR, Tenenbaum, N, Citron, M 1991Greenfield filter as primary therapy for deep venous thrombosis and/or pulmonary embolism in patients with cancerSurgery1091215PubMed
15.
Zurück zum Zitat Sugerman, HJ, Sugerman, EL, Wolfe, L, et al. 2001Risks and benefits of gastric bypass in morbidly obese patients with severe venous stasis diseaseAnn Surg2344146PubMed Sugerman, HJ, Sugerman, EL, Wolfe, L,  et al. 2001Risks and benefits of gastric bypass in morbidly obese patients with severe venous stasis diseaseAnn Surg2344146PubMed
16.
Zurück zum Zitat Duperier, T, Mosenthal, A, Swan, KG, Kaul, S 2003Acute complications associated with Greenfield filter insertion in high-risk trauma patientsJ Trauma4545549CrossRef Duperier, T, Mosenthal, A, Swan, KG, Kaul, S 2003Acute complications associated with Greenfield filter insertion in high-risk trauma patientsJ Trauma4545549CrossRef
17.
Zurück zum Zitat Galster, H, Kolb, G, Kohsytorz, A, Seidlmayer, C, Paal, V 2000The pre-, peri-, and postsurgical activation of coagulation and the thromboembolic risk for different risk groupsThromb Res100381388PubMed Galster, H, Kolb, G, Kohsytorz, A, Seidlmayer, C, Paal, V 2000The pre-, peri-, and postsurgical activation of coagulation and the thromboembolic risk for different risk groupsThromb Res100381388PubMed
18.
Zurück zum Zitat Scurr, JH 1990How long after surgery does the risk of thromboembolism persist?Acta Chir Scand Suppl5562224PubMed Scurr, JH 1990How long after surgery does the risk of thromboembolism persist?Acta Chir Scand Suppl5562224PubMed
19.
Zurück zum Zitat Catre, MG 1997Anticoagulation in spinal surgery. A critical review of the literatureCan J Surg40413419PubMed Catre, MG 1997Anticoagulation in spinal surgery. A critical review of the literatureCan J Surg40413419PubMed
20.
Zurück zum Zitat Rokito, SE, Schwartz, MC, Neuwirth, MG 1996Deep vein thrombosis after major reconstructive spinal surgerySpine218539CrossRef Rokito, SE, Schwartz, MC, Neuwirth, MG 1996Deep vein thrombosis after major reconstructive spinal surgerySpine218539CrossRef
21.
Zurück zum Zitat Oda, T, Fuji, T, Kato, Y, et al. 2000Deep venous thrombosis after posterior spinal surgerySpine2529622967PubMed Oda, T, Fuji, T, Kato, Y,  et al. 2000Deep venous thrombosis after posterior spinal surgerySpine2529622967PubMed
22.
Zurück zum Zitat Tetzlaff, JE, Yoon, HJ, O’Hara, J, et al. 1994Influence of anesthetic technique on the incidence of deep venous thrombosis after elective lumbar spine surgeryReg Anesth1928 Tetzlaff, JE, Yoon, HJ, O’Hara, J,  et al. 1994Influence of anesthetic technique on the incidence of deep venous thrombosis after elective lumbar spine surgeryReg Anesth1928
23.
Zurück zum Zitat West, JL,3rd, Anderson, LD 1992Incidence of deep vein thrombosis in major adult spinal surgerySpine17S254S257PubMed West, JL,3rd, Anderson, LD 1992Incidence of deep vein thrombosis in major adult spinal surgerySpine17S254S257PubMed
24.
Zurück zum Zitat Smith, MD, Bressler, EL, Lonstein, JE, Winter, R, Pinto, MR, Denis, F 1994Deep venous thrombosis and pulmonary embolism after major reconstructive operations on the spine. A prospective analysis of three hundred and seventeen patientsJ Bone Joint Surg Am76980985PubMed Smith, MD, Bressler, EL, Lonstein, JE, Winter, R, Pinto, MR, Denis, F 1994Deep venous thrombosis and pulmonary embolism after major reconstructive operations on the spine. A prospective analysis of three hundred and seventeen patientsJ Bone Joint Surg Am76980985PubMed
25.
Zurück zum Zitat Blebea, J, Wilson, R, Waybill, P, et al. 1999Deep venous thrombosis after percutaneous insertion of vena caval filtersJ Vasc Surg30821829PubMed Blebea, J, Wilson, R, Waybill, P,  et al. 1999Deep venous thrombosis after percutaneous insertion of vena caval filtersJ Vasc Surg30821829PubMed
26.
Zurück zum Zitat Kantor, A, Glanz, S, Gordon, DH, Sclafani, SJ 1987Percutaneous insertion of the Kimray-Greenfield filter: incidence of femoral vein thrombosisA.J.R. Am J Roentgenol14910651066 Kantor, A, Glanz, S, Gordon, DH, Sclafani, SJ 1987Percutaneous insertion of the Kimray-Greenfield filter: incidence of femoral vein thrombosisA.J.R. Am J Roentgenol14910651066
27.
Zurück zum Zitat Prandoni, P, Lensing, AW, Cogo, A, et al. 1996The long-term clinical course of acute deep venous thrombosisAnn Intern Med12517PubMed Prandoni, P, Lensing, AW, Cogo, A,  et al. 1996The long-term clinical course of acute deep venous thrombosisAnn Intern Med12517PubMed
28.
Zurück zum Zitat Marcy, PY, Magne, N, Frenay, M, Bruneton, JN 2001Renal failure secondary to thrombotic complications of suprarenal inferior vena cava filter in cancer patientsCardiovasc Intervent Radiol24257259PubMed Marcy, PY, Magne, N, Frenay, M, Bruneton, JN 2001Renal failure secondary to thrombotic complications of suprarenal inferior vena cava filter in cancer patientsCardiovasc Intervent Radiol24257259PubMed
29.
Zurück zum Zitat Offner, PJ, Hawkes, A, Madayag, R, et al. 2003The role of temporary inferior vena cava filters in critically ill surgical patientsArch Surg138591595PubMed Offner, PJ, Hawkes, A, Madayag, R,  et al. 2003The role of temporary inferior vena cava filters in critically ill surgical patientsArch Surg138591595PubMed
Metadaten
Titel
The Prophylactic Use of Inferior Vena Cava Filters in Patients Undergoing High-Risk Spinal Surgery
verfasst von
Luis Leon, MD
Heron Rodriguez, MD
Rabih G. Tawk, MD
Stephen L. Ondra, MD
Nicos Labropoulos, PhD
Mark D. Morasch, MD
Publikationsdatum
01.05.2005
Erschienen in
Annals of Vascular Surgery / Ausgabe 3/2005
Print ISSN: 0890-5096
Elektronische ISSN: 1615-5947
DOI
https://doi.org/10.1007/s10016-005-0025-1

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