Early experience with the retrievable OptEase vena cava filter in high-risk trauma patients.
OBJECTIVE
Prophylactic vena cava filters (VCF) are efficient in preventing pulmonary embolism. Filter retrieval avoids the potential long-term complications of permanent VCF. Clinical evaluation was focused on filter-related complications and feasibility of retrieval in high-risk trauma patients.


METHODS
Analysis of single-institution consecutive case series of patients who received a prophylactic OptEase VCF after multiple trauma between 08/2003 and 12/2004. Data were collected prospectively.


RESULTS
A total of 37 OptEase filters were inserted prophylactically after multiple trauma (median patient age 35 years, range, 17-73 years, median ISS 41, range, 17-59). All patients had contraindications for pharmacological prophylaxis for thromboembolic events. 32 filters (86%) were retrieved after 16 days (range, 7-25 days). 12 of 33 filters (36%) demonstrated trapped clots/thrombosis within the filter structure on pre-retrieval cavography. Two patients received anticoagulation before filter retrieval due to filter thrombosis (6%). Symptomatic PE was observed in 1 patient (3%) 5 days after VCF retrieval. Minor caudal filter migration was observed in 1 patient (3%). Overall mortality was 3%.


CONCLUSIONS
Retrieval of the OptEase filter is safe and feasible. Temporary filter placement avoids possible long-term complications of permanent VCF. It is an efficient form of PE prophylaxis when temporary contraindications to anticoagulation are present.
Meier
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Division of Trauma Surgery, University Hospital Zurich, Switzerland. christoph.meier@usz.ch
Keller
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Pfiffner
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Labler
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Trentz
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Pfammatter
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D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization; D020878:Device Removal; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control*; D015641:Radiography, Interventional; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D016306:Vena Cava Filters / Q000009:adverse effects