Inferior vena caval filters: review of a 26-year single-center clinical experience.
OBJECTIVE
To review a 26-year single-center clinical experience with inferior vena caval filters.


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 post-filter 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 post-filter 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 post-filter 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.


CONCLUSIONS
Inferior vena caval filters provide protection from life-threatening PE, with minimal morbidity.
Athanasoulis
C A
CA
Department of Radiology, GRB 290A, Massachusetts General Hospital, 32 Fruit St, Boston, MA 02114, USA. athanasoulis.christos@mgh.harvard.edu
Kaufman
J A
JA
Halpern
E F
EF
Waltman
A C
AC
Geller
S C
SC
Fan
C M
CM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000401:mortality / Q000517:prevention & control*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015996:Survival Rate; D013927:Thrombosis / Q000209:etiology; D016306:Vena Cava Filters / Q000009:adverse effects / Q000706:statistics & numerical data