title: Vena Cava Filters are not Superior to Low Molecular Weight Heparin in Venous Thromboembolism Prophylaxis: A Study on Long-Term Immobilized Neurosurgical Patients.
abstract: OBJECTIVE
  Deep venous thrombosis (DVT) and pulmonary embolism (PE) are the most frequent surgical problems and associated with high morbidity and mortality. Neurosurgical patients constitute a unique group where prophylaxis with anticoagulant and antiaggregant agents are relatively contraindicated due to the natural course of vascular problems such as aneurysms, hemorrhagic tumors or hematomas or increased vulnerability to complex spinal surgeries and trauma.
  
  
  METHODS
  We included 67 patients predicted to be immobilized for 2 or more months in this retrospective analysis. A vena cava filter was inserted between the first and seventh postoperative day in 40 patients in a prophylactic manner whereas 27 patients received low dose heparin for the same purpose. The patients were evaluated for symptomatic DVT or PE.
  
  
  RESULTS
  Percutaneous insertion was performed for all filters without any complication. DVT occurred in two patients of the filter group and 1 patient of the heparin group. There was no PE recorded in any patient of either group. Patients were followed up for 22 months in the filter and 16 months in the heparin group.
  
  
  CONCLUSIONS
  We conclude that prophylactic filter use in high risk neurosurgical patients is not beneficial and not superior to low-molecular-weight heparin use. Nevertheless, it is reasonable to prevent PE in patients with proven DVT who have no contraindication for anticoagulant drugs.
authors.affiliation: Ankara Numune Education and Research Hospital, Radiology Clinics, Ankara, Turkey.
authors.forename: Ilkay
authors.initials: I
authors.lastname: Akmangit
authors.forename: Ergun
authors.initials: E
authors.lastname: Daglioglu
authors.forename: Sadik Ahmet
authors.initials: SA
authors.lastname: Uyanik
authors.forename: Baris
authors.initials: B
authors.lastname: Ahlat
authors.forename: Fatih
authors.initials: F
authors.lastname: Alagoz
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ekici
authors.forename: Dogan
authors.initials: D
authors.lastname: Dede
authors.forename: Ahmet Deniz
authors.initials: AD
authors.lastname: Belen
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D011184:Postoperative Period; D011655:Pulmonary Embolism / Q000517:prevention & control; D012189:Retrospective Studies; D016306:Vena Cava Filters; D054556:Venous Thromboembolism / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight