[Interruption of the inferior vena cava in the prevention of pulmonary embolism].
Pulmonary thromboembolism constitutes the third cause of death after cardiovascular accidents and malignant tumours. Prevention is regarded as the most appropriate and effective therapeutic option. Medical antithrombotic therapy is the most common approach, but when antithrombotic therapy with heparin cannot be performed, vena cava filters are necessary devices in many patients and situations. Over the period from 1995 to 2003, 72 patients were admitted to the Surgical Sciences, Orthopaedics, Trauma and Emergency and Biomorphological and Functional Sciences Departments of the Federico II University of Naples. On the basis of their clinical condition and thrombus characteristics, different filters were applied (definitive, temporary, tempofilter). Thorough clinical and imaging follow-up examinations showed the efficacy of vena cava interruption in the prevention of pulmonary embolism, as well as a low complication rate and convenient risk-benefit ratio. Tempofilter, which allows partial interruption of the vena cava for more than 6 weeks, would appear to be the best filtration device. It is effective in the prevention of pulmonary thromboembolism, is durable and does not entail any significant increase in recurrent venous thrombosis, as is the case with definitive vena cava filters.
Milone
Francesco
F
Area Funzionale di Chirurgia Generale, Dipartimento di Scienze Chirurgiche Ortopediche Traumatologiche ed Emergenze, Università degli Studi di Napoli Federico II.
Iaccarino
Vittorio
V
Musella
Mario
M
Salvatore
Giuseppe
G
Venetucci
Piero
P
De Martino
Ciro
C
Milone
Marco
M
D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000517:prevention & control*; D012189:Retrospective Studies; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000601:surgery*