title: The Role of Potentially Retrievable Inferior Vena Cava Filters in High-Risk Patients Undergoing Joint Arthroplasty.
abstract: BACKGROUND
  Some patients undergoing total joint arthroplasty are at increased risk for venous thromboembolism (VTE). The aim of the present study was to evaluate the safety and efficacy of prIVCF in preventing PE in patients undergoing joint replacement surgery who are at high-risk for VTE.
  
  
  METHODS
  In this prospective, IRB-approved study, prIVCF were placed in consecutive patients who met specific high-risk criteria (history of VTE or hypercoaguable state) prior to total joint arthroplasty. Patients were followed until the IVC filter was removed. Outcomes and complications were recorded per Society of Interventional Radiology guidelines.
  
  
  RESULTS
  One hundred and nine potentially retrievable IVC filters were placed in 105 patients, who all subsequently underwent joint arthroplasty. One hundred eight IVC filters (98.9%) were retrieved successfully in a mean time of 44.1 days (range 13-183 days). There was 1 failed IVC filter retrieval attempt (0.9%) at 46 days post implantation. Two patients (1.9%) presented with recurrent PE and were successfully treated with anticoagulation prior to IVC filter retrieval. There were no fatalities from perioperative PE. In 1 patient (0.9%), a fractured filter leg had embolized during retrieval.
  
  
  CONCLUSIONS
  Potentially retrievable IVC filters are safe and effective for prophylaxis against PE in patients at high-risk for VTE undergoing joint arthroplasty.
authors.affiliation: Interventional Radiology Fellow, Department of Radiology, Northwestern University , Chicago .
authors.forename: Sabeen
authors.initials: S
authors.lastname: Dhand
authors.affiliation: Professor, Department of Orthopaedic Surgery, Northwestern University , Chicago .
authors.forename: S David
authors.initials: SD
authors.lastname: Stulberg
authors.affiliation: Associate Professor, Department of Orthopaedic Surgery, Northwestern University , Chicago .
authors.forename: Lalit
authors.initials: L
authors.lastname: Puri
authors.affiliation: Faculty, Department of Radiology, Northwestern University , Chicago .
authors.forename: Jennifer
authors.initials: J
authors.lastname: Karp
authors.affiliation: Professor, Department of Radiology, Northwestern University , Chicago .
authors.forename: Robert K
authors.initials: RK
authors.lastname: Ryu
authors.affiliation: Associate Professor, Department of Radiology, Northwestern University , Chicago .
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Lewandowski
keywords: Deep venous thrombosis; Prophylaxis; Pulmonary embolism; Safety; Venous thromboembolism
references.citation: Cleve Clin J Med. 2008 Apr;75 Suppl 3:S27-36
references.pmid: 18494224
references.citation: J Am Acad Orthop Surg. 2009 Mar;17(3):183-96
references.pmid: 19264711
references.citation: J Vasc Interv Radiol. 2003 Sep;14(9 Pt 2):S427-32
references.pmid: 14514858
references.citation: J Arthroplasty. 2007 Apr;22(3):343-8
references.pmid: 17400088
references.citation: Circulation. 2005 Jul 19;112(3):416-22
references.pmid: 16009794
references.citation: J Bone Joint Surg Am. 1989 Dec;71(10):1542-8
references.pmid: 2592395
references.citation: J Bone Joint Surg Am. 2000 Jul;82-A(7):929-38
references.pmid: 10901307
references.citation: J Vasc Interv Radiol. 2011 Nov;22(11):1499-506
references.pmid: 21890380
references.citation: J Vasc Interv Radiol. 2003 Apr;14(4):425-40
references.pmid: 12682199
references.citation: Cardiovasc Intervent Radiol. 2003 May-Jun;26(3):222-6
references.pmid: 14562968
references.citation: J Vasc Interv Radiol. 2012 Feb;23(2):188-94
references.pmid: 22173108
references.citation: J Vasc Interv Radiol. 2012 Dec;23(12):1557-63
references.pmid: 23177101
references.citation: Chest. 2008 Jun;133(6 Suppl):381S-453S
references.pmid: 18574271
references.citation: JAMA. 2012 Jan 18;307(3):294-303
references.pmid: 22253396
references.citation: J Vasc Interv Radiol. 2008 Mar;19(3):393-9
references.pmid: 18295699
references.citation: J Vasc Interv Radiol. 2010 Dec;21(12):1847-51
references.pmid: 21035356
references.citation: J Vasc Interv Radiol. 2008 Sep;19(9):1321-7
references.pmid: 18725095
references.citation: Spine (Phila Pa 1976). 2012 Jun 1;37(13):1122-9
references.pmid: 22281478
references.citation: N Engl J Med. 2000 Dec 14;343(24):1758-64
references.pmid: 11114314
references.citation: J Vasc Interv Radiol. 1999 Sep;10(8):1013-9
references.pmid: 10496701
references.citation: J Vasc Interv Radiol. 2008 Jun;19(6):884-9
references.pmid: 18503903
references.citation: Am Surg. 2006 Jun;72(6):491-6
references.pmid: 16808200
references.citation: Ann Vasc Surg. 2010 Oct;24(7):946-9
references.pmid: 20831995
references.citation: Neurosurg Focus. 2004 Oct 15;17(4):E6
references.pmid: 15633992
references.citation: Surg Endosc. 2007 Dec;21(12):2277-9
references.pmid: 17440780
references.citation: J Vasc Interv Radiol. 2003 Sep;14(9 Pt 2):S271-5
references.pmid: 14514832
references.citation: Arch Intern Med. 2010 Nov 8;170(20):1827-31
references.pmid: 20696949
references.citation: J Vasc Interv Radiol. 2009 Jul;20(7 Suppl):S374-6
references.pmid: 19560025
references.citation: Clin Appl Thromb Hemost. 2010 Aug;16(4):394-405
references.pmid: 20019020
references.citation: J Arthroplasty. 1991 Jun;6(2):129-35
references.pmid: 1875203
references.citation: Surgery. 1988 Jan;103(1):111-7
references.pmid: 3336860