title: Retrievable vena cava filters in trauma patients for high-risk prophylaxis and prevention of pulmonary embolism.
abstract: BACKGROUND
  Venous thromboembolic (VTE) disease remains a significant cause of morbidity for trauma patients because many patients have injuries that may preclude effective VTE prevention and treatment. Retrievable vena cava filters may prove beneficial in this subset of trauma patients.
  
  
  METHODS
  Trauma patients at risk for VTE were identified and managed by institutional protocol. Patients who required a vena cava filter were managed with a device that could be retrieved or left in situ. A retrospective review of medical records was used to identify the use, indications, and complications associated with a retrievable filter.
  
  
  RESULTS
  Fifty-three retrievable filters were placed in 51 patients. Two of these patients received a second filter, and 1 received a filter in the superior vena cava. Thirty-two filters were placed prophylactically, whereas 21 were placed for demonstrated venous thromboembolism (VTE). Retrieval was successful in 24 of 25 attempts. Twenty-nine filters became permanent: 10 for continued contraindications to anticoagulation without known VTE, 12 for known VTE and continued contraindications to anticoagulation, 1 for technical reasons, and 6 because of patient death. There were no complications of bleeding, device migration or thrombosis, infection, or pulmonary embolism.
  
  
  CONCLUSIONS
  A retrievable vena cava filter appears safe and effective for the prevention of pulmonary embolism in the high-risk trauma patient who cannot receive anticoagulation.
authors.affiliation: Department of Emergency Medicine, Latter Day Saints Hospital, Salt Lake City, UT 84143, USA.
authors.forename: Todd L
authors.initials: TL
authors.lastname: Allen
authors.forename: Jody L
authors.initials: JL
authors.lastname: Carter
authors.forename: Brad J
authors.initials: BJ
authors.lastname: Morris
authors.forename: Colleen P
authors.initials: CP
authors.lastname: Harker
authors.forename: Mark H
authors.initials: MH
authors.lastname: Stevens
mesh_terms: D000925:Anticoagulants; D000075202:Contraindications; D020878:Device Removal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000517:prevention & control*; D014947:Wounds and Injuries / Q000401:mortality / Q000628:therapy*
chemical_list: D000925:Anticoagulants