title: The use of retrievable inferior vena cava filters in orthopaedic patients.
abstract: This study was undertaken to evaluate the safety and efficacy of retrievable inferior vena cava filters in high-risk orthopaedic patients. A total of 58 patients had a retrievable inferior vena cava filter placed as an adjunct to chemical and mechanical prophylaxis, most commonly for a history of previous deep-vein thrombosis or pulmonary embolism, polytrauma, or expected prolonged immobilisation. In total 56 patients (96.6%) had an uncomplicated post-operative course. Two patients (3.4%) died in the peri-operative period for unrelated reasons. Of the 56 surviving patients, 50 (89%) were available for follow-up. A total of 32 filters (64%) were removed without complication at a mean of 37.8 days (4 to 238) after placement. There were four filters (8%) which were retained because of thrombosis at the filter site, and four (8%) were retained because of incorporation of the filter into the wall of the inferior vena cava. In ten cases (20%) the retrievable filter was left in place to continue as primary prophylaxis. No patient had post-removal thromboembolic complications. A retrievable inferior vena cava filter, as an adjunct to chemical and mechanical prophylaxis, was a safe and effective means of reducing the acute risk of pulmonary embolism in this high-risk group of patients. Although most filters were removed without complications, thereby avoiding the long-term complications that have plagued permanent indwelling filters, a relatively high percentage of filters had to be left in situ.
authors.affiliation: Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, 301 East 17th Street, New York, New York 10003, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Strauss
authors.forename: K A
authors.initials: KA
authors.lastname: Egol
authors.forename: M
authors.initials: M
authors.lastname: Alaia
authors.forename: D
authors.initials: D
authors.lastname: Hansen
authors.forename: M
authors.initials: M
authors.lastname: Bashar
authors.forename: D
authors.initials: D
authors.lastname: Steiger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal; D005260:Female; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects; D011655:Pulmonary Embolism / Q000517:prevention & control*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016306:Vena Cava Filters / Q000009:adverse effects*; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000517:prevention & control*