[Inferior vena cava filters. Indications and results in 111 patients].
BACKGROUND
Anticoagulation is the treatment of choice for deep vein thrombosis and pulmonary embolism. Occasionally this treatment is contraindicated or fails to prevent pulmonary embolism. In these patients, inferior cava vein interruption is indicated and filter insertion is the procedure commonly performed.


OBJECTIVE
To report the results of inferior cava vein filter insertions in 111 patients.


METHODS
A retrospective review of patients in whom inferior cava vein filters were inserted was performed.


RESULTS
During the period 1983-1997, filters were inserted in 111 patients (56 female) aged 15 to 93 years old. Indications were pulmonary embolism with contraindication or failure of anticoagulation therapy or poor respiratory function (58 patients), deep vein thrombosis and contraindication for anticoagulation (32 patients) and other indications in 20 patients. In 47 patients, treated before 1993, the insertion required a cut-down. Since then, a percutaneous approach was used in the remaining 64 cases. Three insertion attempts failed, all using cut-down. One of these patients died due to a massive pulmonary embolism. In 88% of the patients the jugular vein was the access site and in 10 patients, the filter was deliberately deployed above the renal veins. There was no mortality or complications. Patients were followed during a maximal period of 147 months and 27 died of unrelated disorders. Survival at 5 and 10 years was 63 and 47% respectively. Symptomatic inferior cava vein obstruction was detected in 5 patients during the follow up period.


CONCLUSIONS
Inferior cava vein filter insertion is a safe measure to prevent pulmonary embolism and its consequences.
Departamento de Enfermedades Cardiovasculares, Pontificia Universidad Católica de Chile, Santiago, Chile.
R
R
Mertens
F
F
Valdés
A
A
Krämer
J
J
Vergara
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants; D000075202:Contraindications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior / Q000601:surgery*
D000925:Anticoagulants
Interrupción de vena cava inferior mediante filtros. Indicaciones y resultados en 111 pacientes.