title: The efficacy of prophylactic IVC filters in gastric bypass surgery.
abstract: BACKGROUND
  Patients undergoing gastric bypass surgery have a high risk for thromboembolic events. Over the last decade, the use of prophylactic IVC filters (IVCF) has drastically increased for patients who are considered high risk. However, the role and efficacy of prophylactic IVCF placement remain controversial, and the literature is limited to a few retrospective studies.
  
  
  METHODS
  We conducted a systematic review of the literature. A total of 21 articles were analyzed, and eight relevant retrospective studies were chosen for review of data. Data from laparoscopic gastric bypass surgery were compared to open gastric bypass surgery
  
  
  RESULTS
  The relevant eight retrospective studies included a total of 597 patients. Patients had IVCFs before laparoscopic gastric bypass (41 %) and before open gastric bypass (59 %). There were 5 postoperative pulmonary emboli (PE) (0.84 %), 21 DVTs (3.52 %), 5 minor IVCF-related complications (0.84 %), 2 major IVCF-related complications (0.34 %), and 10 deaths (1.68 %). The rate of postoperative PE was the same in the laparoscopic group and the open group (0.84 %). The rate of DVT in the laparoscopic group was 5.02 %, and in the open group, it was 2.23 %.
  
  
  CONCLUSIONS
  It is estimated that 55 % of bariatric surgeons use IVCF in high-risk patients. Prospective research that supports the use of IVCF is very limited, and individualized placement relies on retrospective studies only. In addition, patient characteristics associated with high risk vary between different studies. Our review showed that most of the published studies support the use of prophylactic IVCF and found it to be safe. On the other hand, the largest and most recent retrospective cohort study does not support their use. The efficacy of prophylactic IVCFs before gastric bypass surgery in high-risk patients has not been established.
authors.affiliation: Department of Surgery, Easton Hospital, Drexel University College of Medicine, 250 South 21st Street, Easton, PA, 18042, USA, jakubwilhelm@yahoo.com.
authors.forename: B Jakub
authors.initials: BJ
authors.lastname: Wilhelm
authors.forename: Alexey
authors.initials: A
authors.lastname: Markelov
authors.forename: Aniket K
authors.initials: AK
authors.lastname: Sakharpe
authors.forename: Leopoldo M
authors.initials: LM
authors.lastname: Baccaro
authors.forename: Vinay
authors.initials: V
authors.lastname: Singhal
mesh_terms: D015390:Gastric Bypass; D006801:Humans; D010535:Laparoscopy; D011183:Postoperative Complications / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*