title: The use of optional inferior vena cava filters of type Optease in trauma patients--a single type of filter in a single Medical Center.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a frequent complication of patients who experienced major trauma. Prevention of VTE is usually by thrombophylaxis and or by the use of a retrievable filter. Lately, the use of a retrievable filter in trauma patients has increased despite evidence cautioning against its use.
  
  
  OBJECTIVE
  To evaluate complications related to a single type of filter prophylactically used in a tertiary trauma center and search for risk factors that may preclude filter retrieval
  
  
  METHODS
  142 patients aged 16 through 60 who experienced a major trauma and were treated with a prophylactic IVC filter of type optease were evaluated.
  
  
  RESULTS
  The median time from trauma to filter insertion was 2days and low molecular weight heparin at prophylactic dose was initiated in 92% once the filter was inserted. Nine patients developed IVC thrombosis and one of them died despite the use of thrombolytic therapy. Another 8 patients developed lower extremities deep vein thrombosis. The filter was left in place in 13 more patients after attempted filter removal was unsuccessful. Among patients with successful removal, the median dwelling time was 30days. There was no relationship between successful removal and age, sex, BMI, Glasgow coma scale, or injury severity score of patients when first evaluated.
  
  
  CONCLUSIONS
  Of concern is the persistent complications related to IVC filter even with the prophylactic use of anticoagulants and the dose of radiation trauma patients were exposed during insertion and retrieval of filter. Thus, the routine use of IVC filter in trauma patients may not be desirable.
authors.affiliation: Department of Internal Medicine D and Sackler Faculty of Medicine Tel Aviv University, Israel.
authors.forename: Orly
authors.initials: O
authors.lastname: Lavan
authors.affiliation: Diagnostic Imaging Sheba Medical Center and Sackler Faculty of Medicine Tel Aviv University, Israel.
authors.forename: Uri
authors.initials: U
authors.lastname: Rimon
authors.affiliation: Trauma unit Sheba Medical Center, Israel.
authors.forename: Dani
authors.initials: D
authors.lastname: Simon
authors.affiliation: Diagnostic Imaging Sheba Medical Center and Sackler Faculty of Medicine Tel Aviv University, Israel.
authors.forename: Boris
authors.initials: B
authors.lastname: Khaitovich
authors.affiliation: Trauma unit Sheba Medical Center, Israel.
authors.forename: Batia
authors.initials: B
authors.lastname: Segal
authors.affiliation: Department of Internal Medicine D and Sackler Faculty of Medicine Tel Aviv University, Israel.
authors.forename: Ehud
authors.initials: E
authors.lastname: Grossman
authors.affiliation: Diagnostic Imaging Sheba Medical Center and Sackler Faculty of Medicine Tel Aviv University, Israel.
authors.forename: Yeroham
authors.initials: Y
authors.lastname: Kleinbaum
authors.affiliation: Department of Statistics and Operations Research, Faculty of Exact Sciences, Tel Aviv University, Israel.
authors.forename: David M
authors.initials: DM
authors.lastname: Steinberg
authors.affiliation: Thrombosis and Hemostasis Unit and Sheba Medical Center and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel. Electronic address: ophiras@sheba.health.gov.il.
authors.forename: Ophira
authors.initials: O
authors.lastname: Salomon
mesh_terms: D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D000075202:Contraindications; D020878:Device Removal; D004617:Embolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D017984:Enoxaparin / Q000627:therapeutic use; D004867:Equipment Design; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D015912:Thrombolytic Therapy; D013997:Time Factors; D014193:Trauma Centers / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D016306:Vena Cava Filters / Q000009:adverse effects*; D014682:Vena Cava, Inferior; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000517:prevention & control*; D014947:Wounds and Injuries / Q000150:complications / Q000401:mortality / Q000628:therapy*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin
keywords: IVC thrombosis; Optional filter; VTE; low molecular heparin; trauma