1
|
Fioretti AM, La Forgia D, Scicchitano P, Brunetti ND, Inchingolo R, Tocchetti CG, Oliva S. Inferior Vena Cava Filter in Cancer-Associated Thrombosis: A Vade Mecum for the Treating Physicians: A Narrative Review. Biomedicines 2024; 12:2230. [PMID: 39457543 PMCID: PMC11505388 DOI: 10.3390/biomedicines12102230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 09/22/2024] [Accepted: 09/24/2024] [Indexed: 10/28/2024] Open
Abstract
Cancer is a remarkable prothrombotic disease, and cancer-associated thrombosis acts as a dreadful omen for poor prognosis. The cornerstone of venous thromboembolism therapy is anticoagulation; however, in patients with venous thromboembolism who are not suitable for anticoagulation (contraindication, failure, or complication), the inferior vena cava filter appears a valuable option in the therapeutic arsenal. The recently heightened trend of steady rise in filter placement mirrors the spread of retrievable devices, together with improvements in physicians' insertion ability, medico-legal issue, and novel and fewer thrombogenic materials. Nevertheless, the exact role of the inferior vena cava filter in cancer has yet to be endorsed due to a dearth of robust evidence. Indeed, data that support the inferior vena cava filter are weak and even controversial, resulting in discrepancies in the interpretation and application of guidelines in daily practice. In this narrative review, we aim at clarifying the state of the art on inferior vena cava filter use in malignancies. Furthermore, we provide a feasible, conclusive 4-step algorithm for the treating physicians in order to offer a practical strategy to successfully employ the inferior vena cava filter as a priceless device in the current armamentarium against cancer.
Collapse
Affiliation(s)
- Agnese Maria Fioretti
- Cardio-Oncology Unit, IRCCS Istituto Tumori, “Giovanni Paolo II”, 70124 Bari, Italy; (A.M.F.); (S.O.)
| | - Daniele La Forgia
- Breast Radiology Department, IRCCS Istituto Tumori, “Giovanni Paolo II”, 70124 Bari, Italy;
| | - Pietro Scicchitano
- Cardiology-Intensive Care Unit, Ospedale della Murgia “Fabio Perinei”, Altamura, 70022 Bari, Italy
| | | | - Riccardo Inchingolo
- Interventional Radiology Unit, “F. Miulli” Regional General Hospital, Acquaviva, 70021 Bari, Italy;
| | - Carlo Gabriele Tocchetti
- Department of Translational Medical Sciences (DISMET), “Federico II” University of Naples, 80131 Napoli, Italy;
- Center for Basic and Clinical Immunology Research (CISI), “Federico II” University of Naples, 80131 Napoli, Italy
- Interdepartmental Center of Clinical and Translational Sciences (CIRCET), “Federico II” University of Naples, 80131 Napoli, Italy
- Interdepartmental Hypertension Research Center (CIRIAPA), “Federico II” University of Naples, 80131 Napoli, Italy
| | - Stefano Oliva
- Cardio-Oncology Unit, IRCCS Istituto Tumori, “Giovanni Paolo II”, 70124 Bari, Italy; (A.M.F.); (S.O.)
| |
Collapse
|
2
|
Hou W, Fang D, Yin S, Deng Y, Zhang J, Wang S, Liu L, Kong J, Huang M, Zhang X, Dai B, Feng X. Effectiveness and Safety of Early Versus Routine Switching from Low-Molecular-Weight Heparin to Maintenance Therapy of Rivaroxaban for Acute Iliofemoral Vein Thrombosis: A Retrospective Cohort Study. Ann Vasc Surg 2024; 106:152-161. [PMID: 38815910 DOI: 10.1016/j.avsg.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/06/2024] [Accepted: 03/06/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND The anticoagulation strategy of switching to rivaroxaban after 1 week of initial low-molecular-weight heparin (LMWH) therapy is recommended by a guideline for the treatment of acute iliofemoral deep vein thrombosis (DVT). However, the initial rivaroxaban dose in the switching strategy, as well as the effectiveness and safety of the early switching (less than 1 week) to rivaroxaban, remain inadequately substantiated. We aimed to evaluate the effectiveness and safety of early switching from LMWH to maintenance therapy of rivaroxaban (20 mg once daily) for acute iliofemoral DVT. METHODS A retrospective cohort study was conducted using data from patients with acute iliofemoral DVT who received initial LMWH anticoagulation followed by rivaroxaban maintenance therapy. The clinical outcomes were compared between early (LMWH course ≤7 days) and routine (LMWH course >7 days) switching strategies within 3 months of initiating anticoagulation. RESULTS 217 patients were included, 59 (27.2%) receiving early switching and 158 (72.8%) receiving routine switching. Compared with routine switching, patients with early switching had a significantly shorter hospital stay (7 days vs. 14 days, P < 0.001). The length of hospital stay was significantly positively correlated with the duration of LMWH (r = 0.762, P < 0.001). The incidences of recurrent venous thromboembolism (5.1% vs. 2.5%, P = 0.606), major bleeding (0% vs. 1.9%, P = 0.564), clinically relevant nonmajor bleeding (1.7% vs. 2.5%, P = 1.000) and all-cause mortality (6.8% vs. 2.5%, P = 0.283) were not statistically different between the 2 groups. CONCLUSIONS Direct early switching from LMWH to maintenance therapy of rivaroxaban is effective and safe for acute iliofemoral DVT.
Collapse
Affiliation(s)
- Wei Hou
- Department of Pharmacy, Tianjin Hospital, Tianjin, China
| | - Demin Fang
- Department of Pharmacy, Tianjin Hospital, Tianjin, China
| | - Shugang Yin
- Department of Vascular Surgery, Tianjin Hospital, Tianjin, China
| | - Yajing Deng
- Department of Pharmacy, Tianjin Hospital, Tianjin, China
| | - Jinhong Zhang
- Department of Pharmacy, Tianjin Hospital, Tianjin, China
| | - Siting Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Liguo Liu
- Department of Vascular Surgery, Tianjin Hospital, Tianjin, China
| | - Jingbo Kong
- Department of Vascular Surgery, Tianjin Hospital, Tianjin, China
| | - Mei Huang
- Department of Vascular Surgery, Tianjin Hospital, Tianjin, China
| | - Xiujun Zhang
- Department of Vascular Surgery, Tianjin Hospital, Tianjin, China
| | - Bin Dai
- Department of Pharmacy, Tianjin Hospital, Tianjin, China
| | - Xin Feng
- Department of Pharmacy, Tianjin Hospital, Tianjin, China.
| |
Collapse
|
3
|
Banks CA, Passman MA. Appropriateness guidelines for inferior vena cava filter utilization: A contemporary review. Semin Vasc Surg 2024; 37:164-178. [PMID: 39151996 DOI: 10.1053/j.semvascsurg.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 08/19/2024]
Abstract
Concern regarding the exponential increase in optional utilization of inferior vena cava filters (IVCFs) in the early 2000s with a persistent low retrieval rate nationwide has resulted in increased scrutiny regarding clinical application of IVCFs. IVCFs are used in a variety of clinical scenarios, ranging from thromboembolic protection in patients with deep venous thrombosis and contraindication to anticoagulation to prophylactic deployment in multitrauma and critically ill patients. Evidence supporting IVCFs as mechanical thromboembolic protection in certain clinical scenarios has been established through evidenced-based guidelines. As an adjunct to evidence-based guidelines, appropriateness criteria to address specific clinical scenarios and facilitate clinical decision making when considering placement of an IVCF have been developed. In this review, current evidence-based and appropriateness guidelines are summarized.
Collapse
Affiliation(s)
- C Adam Banks
- Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, AL
| | - Marc A Passman
- Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, AL.
| |
Collapse
|
4
|
Dehbi S, Grange R, Poenou G, Ayoub E, Boutet C, Barral FG, Bertoletti L, Grange S. Temporary inferior vena cava filters factors associated with non-removal. Eur Radiol 2023; 33:2585-2592. [PMID: 36517606 DOI: 10.1007/s00330-022-09266-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 07/26/2022] [Accepted: 10/09/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Inferior vena cava filter (IVCF) placement is indicated when there is a deep vein thrombosis and/or a pulmonary embolism and a contraindication of anticoagulation. Due to the increased risk of recurrent deep venous thrombosis when left in place, IVCF removal is indicated once anticoagulant treatment can be reintroduced. However, many temporary IVCF are not removed. We aimed to analyze the removal rate and predictors of filter non-removal in a university hospital setting. METHODS We collected all the data of consecutive patients who had a retrievable IVCF inserted at the Saint-Etienne University Hospital (France) between April 2012 and November 2019. Rates of filter removal were calculated. We analyzed patient characteristics to assess factors associated with filter non-removal, particularly in patients without a definitive filter indication. The exclusion of this last category of patients allowed us to calculate an adjusted removal rate. RESULTS The overall removal rate of IVCF was 40.5% (IC 95% 35.6-45.6), and the adjusted removal rate was 62.9 % (IC 95% 56.6-69.2%). No major complications were noted. Advanced age (p < 0.0001) and cancer presence (p < 0.003) were statistically significant predictors of patients not being requested to make a removal attempt. CONCLUSIONS Although most of the filters placed are for therapeutic indications validated by scientific societies, the removal rate in this setting remains suboptimal. The major factors influencing IVCF removal rate are advanced age and cancer presence. KEY POINTS • Most vena cava filters are placed for therapeutic indications validated by scientific societies. • Vena cava filter removal rates in this setting remain suboptimal. • Major factors influencing IVCF removal rate are advanced age and cancer presence.
Collapse
Affiliation(s)
- Sabrina Dehbi
- CHU de St-Etienne, Service de Radiologie, Hôpital Nord, CHU de St-Etienne, Avenue Albert Raimond, Saint-Etienne, France
| | - Rémi Grange
- CHU de St-Etienne, Service de Radiologie, Hôpital Nord, CHU de St-Etienne, Avenue Albert Raimond, Saint-Etienne, France
| | - Geraldine Poenou
- CHU de St-Etienne, Service de Médecine Vasculaire et Thérapeutique, Hôpital Nord, CHU de St-Etienne, Saint-Etienne, Avenue Albert Raimond, Saint-Etienne, France
| | - Elie Ayoub
- CHU de St-Etienne, Service de Médecine Vasculaire et Thérapeutique, Hôpital Nord, CHU de St-Etienne, Saint-Etienne, Avenue Albert Raimond, Saint-Etienne, France
| | - Claire Boutet
- CHU de St-Etienne, Service de Radiologie, Hôpital Nord, CHU de St-Etienne, Avenue Albert Raimond, Saint-Etienne, France
| | - Fabrice-Guy Barral
- CHU de St-Etienne, Service de Radiologie, Hôpital Nord, CHU de St-Etienne, Avenue Albert Raimond, Saint-Etienne, France
| | - Laurent Bertoletti
- CHU de St-Etienne, Service de Médecine Vasculaire et Thérapeutique, Hôpital Nord, CHU de St-Etienne, Saint-Etienne, Avenue Albert Raimond, Saint-Etienne, France
- INSERM, UMR1059, Equipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, F-42055, Saint-Etienne, France
- INSERM, CIC-1408, CHU Saint-Etienne, F-42055, Saint-Etienne, France
| | - Sylvain Grange
- CHU de St-Etienne, Service de Radiologie, Hôpital Nord, CHU de St-Etienne, Avenue Albert Raimond, Saint-Etienne, France.
| |
Collapse
|
5
|
Ramachandran R, Kumar V, Grantham T, Etienne D, Reddy M. Conservative Management of Duodenal Penetration by Inferior Vena Cava Filter: Case Report and Review. J Investig Med High Impact Case Rep 2023; 11:23247096231192815. [PMID: 37610107 PMCID: PMC10460035 DOI: 10.1177/23247096231192815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 08/24/2023] Open
Abstract
Duodenal penetration is a late complication associated with the placement of inferior vena cava (IVC) filters. In this case report, we are presenting a case of asymptomatic duodenal penetration by IVC filter that was managed conservatively.
Collapse
Affiliation(s)
| | - Vikash Kumar
- Department of Internal Medicine, The Brooklyn Hospital Center, NY, USA
| | - Tyler Grantham
- Department of Internal Medicine, Staten Island University Hospital, NY, USA
| | - Denzil Etienne
- Department of Gastroenterology, The Brooklyn Hospital Center, NY, USA
| | - Madhavi Reddy
- Department of Gastroenterology, The Brooklyn Hospital Center, NY, USA
| |
Collapse
|
6
|
Ibero-American Society of Interventionism (SIDI) and the Spanish Society of Vascular and Interventional Radiology (SERVEI) Standard of Practice (SOP) for the Management of Inferior Vena Cava Filters in the Treatment of Acute Venous Thromboembolism. J Clin Med 2021; 11:jcm11010077. [PMID: 35011826 PMCID: PMC8745208 DOI: 10.3390/jcm11010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/06/2021] [Accepted: 12/10/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives: to present an interventional radiology standard of practice on the use of inferior vena cava filters (IVCFs) in patients with or at risk to develop venous thromboembolism (VTE) from the Iberoamerican Interventional Society (SIDI) and Spanish Vascular and Interventional Radiology Society (SERVEI). Methods: a group of twenty-two interventional radiologist experts, from the SIDI and SERVEI societies, attended online meetings to develop a current clinical practice guideline on the proper indication for the placement and retrieval of IVCFs. A broad review was undertaken to determine the participation of interventional radiologists in the current guidelines and a consensus on inferior vena cava filters. Twenty-two experts from both societies worked on a common draft and received a questionnaire where they had to assess, for IVCF placement, the absolute, relative, and prophylactic indications. The experts voted on the different indications and reasoned their decision. Results: a total of two-hundred-thirty-three articles were reviewed. Interventional radiologists participated in the development of just two of the eight guidelines. The threshold for inclusion was 100% agreement. Three absolute and four relative indications for the IVCF placement were identified. No indications for the prophylactic filter placement reached the threshold. Conclusion: interventional radiologists are highly involved in the management of IVCFs but have limited participation in the development of multidisciplinary clinical practice guidelines.
Collapse
|
7
|
Jianping G, Razi M, Xu H, Ahmed M. Inferior vena cava filter thrombosis: An overview. INDIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY 2020. [DOI: 10.4103/ijves.ijves_118_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
8
|
|
9
|
Park HO, Choi JY, Jang IS, Kim JD, Kim JW, Byun JH, Kim SH, Yang JH, Moon SH, Kim KN, Kang DH, Jung JJ, Choi SM, Kim JY, Lee CE. Perforation of inferior vena cava and duodenum by strut of inferior vena cava filter: A case report. Medicine (Baltimore) 2019; 98:e17835. [PMID: 31764778 PMCID: PMC6882657 DOI: 10.1097/md.0000000000017835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION An Inferior vena cava (IVC) filter is an intravascular filter that is implanted into the IVC to prevent pulmonary embolism in medical, surgical, and trauma patients. The insertion of an IVC filter is a relatively safe procedure, but rarely may be associated with symptomatic perforation of the IVC wall, particularly in the long term. PATIENT CONCERNS AND DIAGNOSIS A 74-year-old-woman with a medical history of IVC filter insertion visited the emergency department complaining of abdominal pain. A computed tomography scan showed perforation of the IVC wall and penetration into the duodenum by one of the filter's struts. INTERVENTIONS We performed a laparotomy to remove the IVC filter. OUTCOMES Postoperatively, the patient was admitted to the general ward. On hospital day 12, she was discharged without any complications. We followed her up and computed tomography did not show any abnormal findings six months after discharge. LESSONS There is currently no evidence testifying to the benefits of IVC filter removal. Detailed, evidence-based guidelines on the indications, timing and procedure for IVC filter removal are needed. Documenting cases of long-term complications of IVC filter s such as in this patient serve to accelerate the publication of updated guidelines and are aimed at improving outcomes of similar cases in the future.
Collapse
Affiliation(s)
- Hyun Oh Park
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju
| | - Jun Young Choi
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju
| | - In Seok Jang
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju
| | - Jong Duk Kim
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju
| | - Jong Woo Kim
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon
| | - Joung Hun Byun
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon
| | - Sung Hwan Kim
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon
| | - Jun Ho Yang
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon
| | - Seong Ho Moon
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon
| | - Ki Nyun Kim
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon
| | - Dong Hun Kang
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon
| | - Jae Jun Jung
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon
| | | | - Ji Yoon Kim
- Department of Anesthesiology and Pain Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Chung Eun Lee
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju
| |
Collapse
|
10
|
Örgel M, Aschoff HH, Krettek C, Graulich T, Omar M, Harb A, Alazzawi S. Perioperative mortality secondary to a pulmonary embolism during a surgical implantation of the Endo-Exo-Prosthesis: a case report. ESC Heart Fail 2019; 6:1092-1095. [PMID: 31290287 PMCID: PMC6816062 DOI: 10.1002/ehf2.12489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 04/10/2019] [Accepted: 06/07/2019] [Indexed: 11/25/2022] Open
Abstract
We report on a 53‐year‐old female patient who suffered a perioperative death secondary to a pulmonary embolism (PE) during an implantation of Endo‐Exo‐Prosthesis. This is a retrospective review of medical case for a patient who had a previous above‐the‐knee amputation secondary to a failed previous arthroplasty surgery. Our planned surgery was a stage 1 implantation of an Endo‐Exo‐Prosthesis, and it was performed under general anaesthesia. After 25 min from starting the surgical procedure, the patient sustained a cardiac arrest, and despite an active cardiopulmonary resuscitation for 50 min, the patient did not recover, the ventilator machine was stopped later on, and the patient was declared deceased at that stage. Fatal intraoperative PE is a rare but significant complication during orthopaedic procedures. There are few reports of similar events but include mainly trauma patients with fractured neck of femur. Endo‐Exo‐Prosthesis is a relatively newly evolved procedure in a unique group of patients. To our knowledge, this is the first case report of such complication during Endo‐Exo‐Prosthesis implantation. Patient and surgeon should be aware of it, and additional preventive measures like preoperative scoring systems and in special cases using inferior vena cava filter should be considered in patients with high risk of developing venous thromboembolism.
Collapse
Affiliation(s)
- Marcus Örgel
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Horst-Heinrich Aschoff
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Christian Krettek
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Tilman Graulich
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Mohamed Omar
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Afif Harb
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Sulaiman Alazzawi
- Orthopaedic Department, UBC Hospital, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| |
Collapse
|