Current trends in vena caval filtration with the introduction of a retrievable filter at a level I trauma center.
OBJECTIVE
The purpose of this study was to document the initial experience, indications, technical success, and complications with an optional vena caval filter at a Level I trauma center.


METHODS
The trauma registry and interventional radiology database were reviewed for all venal caval filters placed during a 15-month period. Records were reviewed for age of patient, indication, type of filter, and duration between placement and removal of the filter.


RESULTS
One hundred thirty-six filters were placed into 130 patients (55 trauma patients), and the most frequently placed filter was the Günther Tulip (n = 58, 29 in trauma patients). Forty-five of 1,257 trauma patients received a prophylactic vena cava filter, for a rate of 4%. Twenty-two repositioning (n = 8) or removal procedures (n = 14, 9 in trauma patients) were performed in 15 patients, with a technical success rate of 93%. No minor complications and one major complication occurred. The average duration between placement and removal was 19 days (range, 11-41 days). The mean age of patients selected prospectively for filter removal (29 years; range, 18-71 years) was significantly lower than the mean age (49 years; range, 19-82 years) of trauma, surgical, and intracranial hemorrhage patients selected for placement of prophylactic permanent filters (p < 0.002; 95% confidence interval, 18.0-22.4).


CONCLUSIONS
The Günther Tulip filter is commonly used at this Level I trauma center as an optional filter that can be left in place as a permanent filter or removed up to 41 days after placement. Without an intervening repositioning procedure, the manufacturer suggests that the Günther Tulip filter can be safely removed within 14 days of implantation, or it can remain in place as a permanent filter.
Department of Radiology, University of Vermont College of Medicine, Fletcher Allen Health Care, Burlington, Vermont, USA. christopher.morris@vtmednet.org
Christopher S
CS
Morris
Frederick B
FB
Rogers
Kenneth E
KE
Najarian
Anant D
AD
Bhave
Steven R
SR
Shackford
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000628:therapy*; D004638:Emergency Treatment / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000517:prevention & control*; D011859:Radiography; D012042:Registries; D012189:Retrospective Studies; D014193:Trauma Centers; D016306:Vena Cava Filters / Q000706:statistics & numerical data*; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging*; D014707:Vermont / Q000453:epidemiology