Inferior vena cava filters in trauma patients: efficacy, morbidity, and retrievability.
BACKGROUND
Thromboembolic events are potentially devastating sources of morbidity in trauma patients. With increasing experience and the introduction of retrievable devices, there has been a renewed interest in inferior vena cava (IVC) filters in trauma patients.


METHODS
The records for consecutive trauma patients undergoing IVC filter placement during the years 2001 to 2005 were reviewed, and clinical, demographic, and procedural data were evaluated for associations with thromboembolic events and device complications.


RESULTS
During the study years, 226 trauma patients had IVC filters inserted, and 140 of these patients (62%) had retrievable IVC filters placed. Six patients (3%) had a pulmonary embolism with the filter in place, and two patients (1%) had a pulmonary embolism after filter removal. The most common complication was thrombosis in 27 patients (12%), with clinically significant thrombus occurring in 15 patients (7%). There was no association between the type of filter (permanent or retrievable) or the brand of retrievable filter and thrombosis. Specific risk factors for thrombosis could not be identified. Retrievable filters were successfully removed in 61% of patients with retrievable filters. Technical success rate was 97% in those patients who underwent attempted removal. Removal was completed at a median of 21 days (range, 2-292 days).


CONCLUSIONS
Retrievable IVC filters in trauma patients are safe, but complications do occur with thrombosis being the most common. Retrieval has a high technical success rate when attempted. However, a significant number of trauma patients are lost to follow-up and this may impact the utilization of retrievable filters in this patient population.
Smoot
Rory L
RL
Division of Trauma, Critical Care, and General Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Koch
Cody A
CA
Heller
Stephanie F
SF
Sabater
Enrique A
EA
Cullinane
Daniel C
DC
Bannon
Michael P
MP
Thomsen
Kristine M
KM
Harmsen
William S
WS
Baerga-Varela
Yvonne
Y
Schiller
Henry J
HJ
D020878:Device Removal; D004869:Equipment Safety; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology* / Q000517:prevention & control*; D012307:Risk Factors; D016896:Treatment Outcome; D016306:Vena Cava Filters; D014947:Wounds and Injuries / Q000150:complications*