Gunther tulip inferior vena cava filter placement during treatment for deep venous thrombosis of the lower extremity.
OBJECTIVE
To evaluate the efficacy and safety of Gunther tulip retrievable vena cava filter (GTF) implantation to prevent pulmonary embolism during intravenously administered thrombolytic and anticoagulation therapy and interventional radiological therapy for occlusive or nonocclusive deep venous thrombosis (DVT) of the lower extremity.


METHODS
We evaluated placement of 55 GTFs in 42 patients with lower extremity DVT who had undergone various treatments including those utilizing techniques of interventional radiology.


RESULTS
Worsening of pulmonary embolism in patients with existing pulmonary embolism or in those without pulmonary embolism at the time of GTF insertion was avoided in all patients. All attempts at implantation of the GTF were safely accomplished. Perforation and migration experienced by one patient was the only complication. Mean period of treatment for DVT under protection from pulmonary embolism by the GTF was 12.7 +/- 8.3 days (mean +/- SD, range 4-37 days). We attempted retrieval of GTFs in 18 patients in whom the venous thrombus had disappeared after therapy, and retrieval in one of these 18 cases failed. GTFs were left in the vena cava in 24 patients for permanent use when the DVT was refractory to treatment.


CONCLUSIONS
The ability of the GTF to protect against pulmonary embolism during treatment of DVT was demonstrated. Safety in both placement and retrieval was clarified. Because replacement with a permanent filter was not required, use of the GTF was convenient when further protection from complicated pulmonary embolism was necessary.
Yamagami
Takuji
T
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoj, Kyoto, Kamigyo, 602-8566, Japan. yamagami@koto.kpum.ac.jp
Kato
Takeharu
T
Iida
Shigeharu
S
Hirota
Tatsuya
T
Nishimura
Tsunehiko
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology* / Q000517:prevention & control*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000150:complications* / Q000628:therapy*