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Abstract
Venous thromboembolism (VTE) is a common complication among patients in the intensive care unit. While anticoagulation remains standard therapy, vena caval filters are an important alternative when anticoagulation is contraindicated. To determine the safety and efficacy of vena caval filters in the treatment of VTE, a comprehensive review of the English-language medical literature was performed. Except for one randomized controlled trial, the literature supporting the use of vena caval filters consists almost exclusively of case series, which in many instances are limited by incomplete and short follow-up. While case series suggest that filters function effectively in the prevention of pulmonary embolism (2%-4% symptomatic pulmonary embolism [PE], fatal PE < 2%), recent higher quality studies indicate that filters may not provide significant additional protection to that provided by anticoagulation alone. Furthermore, filters are associated with a 2- fold increase in the incidence of recurrent DVT. Until randomized comparative studies are available, the safety and efficacy of all the available devices should be considered to be roughly equivalent. Since filters do not inhibit continued clot formation, all filter patients should receive anticoagulation for durations appropriate for their thrombotic disorder. Although extended anticoagulation may prevent thrombotic complications associated with filter placement, this strategy has yet to be experimentally tested. While many additional indications for vena caval filter use have been proposed (VTE in cancer patients, PE prophylaxis in trauma patients, etc), well-designed clinical trials demonstrating their efficacy in these situations are lacking. Further development of temporary/retrievable filters, which offer the potential to avoid the long-term complications of permanent filters, should be a research priority. Until additional data are available, vena caval filters should generally be restricted to patients with VTE who cannot receive anticoagulation.
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Affiliation(s)
- Michael B Streiff
- Department of Medicine, Division of Hematology, Johns Hopkins University School of Medicine, Ross Research Building, Room 1025, 720 Rutland Avenue, Baltimore, MD 21205, USA
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2
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Ayyathurai R, Garcia-Roig M, Gorin MA, González J, Manoharan M, Kava BR, Soloway MS, Ciancio G. Bland thrombus association with tumour thrombus in renal cell carcinoma: analysis of surgical significance and role of inferior vena caval interruption. BJU Int 2012; 110:E449-55. [DOI: 10.1111/j.1464-410x.2012.11128.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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3
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de Brito Galvao JF, Chew DJ. Metabolic complications of endocrine surgery in companion animals. Vet Clin North Am Small Anim Pract 2011; 41:847-68, v. [PMID: 21889689 DOI: 10.1016/j.cvsm.2011.05.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Metabolic complications of endocrine surgery occur commonly and precautions should be taken to avoid potentially life-threatening situations and to lessen expense associated with a more extended hospital stay. Common complications of endocrine surgery as well as prevention strategies will be reviewed for pancreatic, parathyroid, and adrenal surgery.
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Affiliation(s)
- Joao Felipe de Brito Galvao
- Small Animal Internal Medicine, The Ohio State University, 601 Vernon Tharp Street, Columbus, OH 43210, USA.
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4
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Intraoperative pulmonary embolism due to nephrectomy for renal carcinoma: Value of perioperative monitoring and immediate embolectomy using cardiopulmonary bypass. Int J Angiol 2011. [DOI: 10.1007/bf02043210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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5
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Kwon TW, Kim H, Moon KM, Cho YP, Song C, Kim CS, Ahn H. Surgical treatment of inferior vena cava tumor thrombus in patients with renal cell carcinoma. J Korean Med Sci 2010; 25:104-9. [PMID: 20052355 PMCID: PMC2800013 DOI: 10.3346/jkms.2010.25.1.104] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Accepted: 02/17/2009] [Indexed: 12/12/2022] Open
Abstract
Radical nephrectomy with inferior vena cava (IVC) thrombectomy remains the most effective therapeutic option in patients with renal cell carcinoma and IVC tumor thrombus. Cephalic extension of the thrombus is closely related to perioperative morbidity. We purposed to design a safe and successful surgical strategy through a review of our surgical experience and treatment results in 35 patients (male:female=28:7, mean age=56 yr [32-77]) who underwent IVC thrombectomy with radical nephrectomy between January 1997 and December 2006. The limit of tumor extension was level I in 10 patients (28.6%), level II in 17 (48.6%), and level III and IV in 4 patients each (11.4%). Liver mobilization with hepatic vascular exclusion was performed in 12 patients and cardiopulmonary bypass in 7. Thirty-two primary closures, 2 patch closures, and 1 graft interposition were performed. One patient underwent simultaneous pulmonary embolectomy because of an operative pulmonary embolism. There was no operative mortality, and the overall survival at 5-yr was 50.8%. Complete thrombus removal without tumor fragmentation under long venotomy on fully exposed involved IVC is recommended for successful result in a bloodless operative field. The applicability of liver mobilization, hepatic vascular exclusion, and cardiopulmonary bypass, can be determined by the level of thrombus.
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Affiliation(s)
- Tae-Won Kwon
- Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea.
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6
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Bihorac A, Kitchens CS. Successful thrombolytic therapy for acute kidney injury secondary to thrombosis of suprarenal inferior vena cava filter. J Thromb Thrombolysis 2009; 28:500-5. [DOI: 10.1007/s11239-009-0359-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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7
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Retrievable Günther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep venous thrombosis in perinatal period. Eur J Radiol 2009; 70:165-9. [DOI: 10.1016/j.ejrad.2007.12.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2007] [Revised: 12/12/2007] [Accepted: 12/13/2007] [Indexed: 11/24/2022]
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8
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Ban D, Yamamoto S, Kuno H, Fujimoto H, Fujita S, Akasu T, Moriya Y. A case of huge colon carcinoma and right renal angiomyolipoma accompanied by proximal deep venous thrombosis, pulmonary embolism and tumor thrombus in the renal vein. Jpn J Clin Oncol 2008; 38:710-4. [PMID: 18845524 DOI: 10.1093/jjco/hyn094] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A preoperative inferior vena cava (IVC) filter is reported to be effective in surgical cases with proximal deep venous thrombosis (DVT) or in which pulmonary embolism (PE) has already developed, and considered to be at high risk of developing secondary fatal PE during or after surgery. However, guidelines for using an IVC filter have yet to be established. The patient in the present report had two huge tumors, ascending colon cancer and renal angiomyolipoma, which occupied the entire right half of the abdomen, coexisting PE, DVT and tumor thrombus in the right renal vein. Secondary PE is fatal in the perioperative period, therefore, the vena cava filters were preoperatively inserted into the supra- and the infrarenal IVC. We successfully removed the tumors without complications. The patient is alive without tumor recurrence and PE or recurrent DVT 1 year and 6 months after surgery. The coexistence of two huge abdominal tumors as potential causes of PE and DVT is extremely rare, and we could have safely undergone the operation, using two vena cava filters in the supra- and infrarenal IVC.
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Affiliation(s)
- Daisuke Ban
- Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
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Sakai Y, Masuda H, Arai G, Kobayashi T, Kageyama Y, Kihara K. Accidental dislocation of an intracaval temporary filter into the heart in a case of renal cell carcinoma extending into the vena cava. Int J Urol 2006; 13:1118-20. [PMID: 16903941 DOI: 10.1111/j.1442-2042.2006.01510.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In a case of renal cell carcinoma extending into the vena cava, a temporary intracaval filter was applied before surgery to prevent pulmonary artery thrombosis. Two days later, the filter accidentally migrated into the right ventricle during defecation. Fortunately, it was successfully removed without damaging cardiac musculature under fluoroscopy.
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Affiliation(s)
- Yasuyuki Sakai
- Department of Urology and Reproductive Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
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Liu WC, Do YS, Choo SW, Kim DI, Kim YW, Kim DK, Shin SW, Park KB, Jeon YH, Choo IW. The mid-term efficacy and safety of a permanent nitinol IVC filter(TrapEase). Korean J Radiol 2005; 6:110-6. [PMID: 15968150 PMCID: PMC2686418 DOI: 10.3348/kjr.2005.6.2.110] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective 1) To evaluate the mid-term efficacy and safety of a permanent nitinol inferior vena cava (IVC) filter; 2) to evaluate filter effectiveness, filter stability and caval occlusion. Materials and Methods A prospective evaluation of the TrapEase IVC filter was performed on 42 patients (eight men, 34 women) ranging in age from 22 to 78 years (mean age 66 years). All patients were ill with a high risk of pulmonary embolism (PE). Indications for filter placement were: 1) deep vein thrombosis with recurrent thromboembolism; 2) and/or free-floating thrombus with contraindication to anticoagulation; and 3) complications in achieving adequate anticoagulation. Follow-up evaluations (mean: 15.4 months, range: 2 to 28 months) were performed at 6- and 12-month intervals after the procedure and included clinical histories, chart reviews, plain film, Doppler ultrasounds, and contrasted abdominal CT scans. Results In follow-up evaluations, the data analysis revealed no cases of symptomatic PE. There were no cases of filter migration, insertion site thrombosis, filter fracture, or vessel wall perforation. During the study, there was one case of filter thrombosis; early symptomatic thrombosis that was successfully treated in the hospital. Of the 42 subjects, eight died. These deaths were not related to the filter device or the implantation procedure, but to the underlying disease. Conclusion This study demonstrates that the TrapEase permanent IVC filter is a safe and an effective device with low complication rates and is best used in patients with thromboembolic disease with a high risk of PE.
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Affiliation(s)
- Wei Chiang Liu
- Department of Radiology, Sung-Ae General Hospital, Korea
| | - Young Soo Do
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
| | - Sung Wook Choo
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
| | - Dong-Ik Kim
- Department of Surgery, Cardiovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
| | - Young Wook Kim
- Department of Surgery, Cardiovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
| | - Duk-Kyung Kim
- Department of Internal Medicine, Cardiovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
| | - Sung Wook Shin
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
| | - Kwang Bo Park
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
| | - Yong Hwan Jeon
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
| | - In-Wook Choo
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
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11
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Kawamata K, Chiba Y, Tanaka R, Higashi M, Nishigami K. Experience of temporary inferior vena cava filters inserted in the perinatal period to prevent pulmonary embolism in pregnant women with deep vein thrombosis. J Vasc Surg 2005; 41:652-6. [DOI: 10.1016/j.jvs.2005.01.023] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Peacock JT, Fossum TW, Bahr AM, Miller MW, Edwards JF. Evaluation of gradual occlusion of the caudal vena cava in clinically normal dogs. Am J Vet Res 2003; 64:1347-53. [PMID: 14620768 DOI: 10.2460/ajvr.2003.64.1347] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To devise a technique for gradual occlusion of the caudal vena cava in dogs and determine effects of complete occlusion of the caudal vena cava. ANIMALS 8 mixed-breed hounds that weighed between 25 and 30 kg. PROCEDURE Baseline evaluation of dogs included serum biochemical analyses and determination of glomerular filtration rate (GFR) with dynamic renal scintigraphy and plasma clearance analysis. An occluder was placed around the vena cava in the region cranial to the renal veins. The occluder was attached to a vascular access port. The vena cava was gradually occluded over 2 weeks. The GFR was measured every 2 weeks after surgery, and venograms were performed every 3 weeks after surgery. Blood samples were collected every 48 hours for the first week and then weekly thereafter to measure BUN and creatinine concentrations and activities of alanine transaminase, alkaline phosphatase, and creatinine kinase. Dogs were euthanatized 6 weeks after surgery, and tissues were submitted for histologic examination. The GFR and biochemical data were compared with baseline values. RESULTS Gradual occlusion of the caudal vena cava was easily and consistently performed with this method, and adverse clinical signs were not detected. Formation of collateral vessels allowed overall GFR to remain constant despite a decrease in function of the left kidney. Measured biochemical values did not deviate from reference ranges. CONCLUSIONS AND CLINICAL RELEVANCE Gradual occlusion of the caudal vena cava may allow removal of adrenal gland tumors with vascular invasion that would otherwise be difficult or impossible to resect.
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Affiliation(s)
- John T Peacock
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA
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13
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Rogers F, Lawler C. Dislodgement of an inferior vena cava filter during central line placement in an ICU patient: a case report. Injury 2001; 32:787-8. [PMID: 11754887 DOI: 10.1016/s0020-1383(01)00049-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- F Rogers
- Department of Surgery, Fletcher Allan Health Care, Fourth Floor, Fletcher House, 111 Colchester Avenue, Burlington, VT 05401, USA.
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Rousseau H, Perreault P, Otal P, Stockx L, Golzarian J, Oliva V, Reynaud P, Raat F, Szatmari F, Santoro G, Emanuelli G, Nonent M, Hoogeveen Y. The 6-F nitinol TrapEase inferior vena cava filter: results of a prospective multicenter trial. J Vasc Interv Radiol 2001; 12:299-304. [PMID: 11287505 DOI: 10.1016/s1051-0443(07)61907-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
PURPOSE The authors report the first results of a new 6-F symmetrically designed permanent nitinol inferior vena cava (IVC) filter, the Cordis TrapEase, evaluated in a multicenter prospective study with 6-months of follow-up. MATERIALS AND METHODS A total of 65 patients (29 men, 36 women) who ranged in age from 37 to 96 years (mean age, 68 years) and who were at high risk of pulmonary embolism (PE) were enrolled in 12 centers in Europe and Canada. The study was approved by the institutional review boards at all centers. Study objectives were to evaluate filter effectiveness, filter stability, and caval occlusion. Indications for filter placement were deep vein thrombosis with recurrent thromboembolism and/or free-floating thrombus with contraindication to anticoagulation in 37 patients, and complications in achieving adequate anticoagulation in 28 patients. Follow-up included clinical examination, plain film, Doppler ultrasound, CT scan, and nuclear medicine. RESULTS The analysis of the data revealed a technical success of 95.4% (three filter-system related implantations not at the intended site, no events of filter tilting) and a clinical success of 100% at 6 months (no cases of symptomatic PE), the study primary endpoint. There were no cases (0%) of filter migration, insertion site thrombosis, filter fracture, or vessel wall perforation. During the study period, there were two cases of filter thrombosis: one case of early symptomatic thrombosis that was successfully treated in the hospital, and one case of nonsymptomatic filter thrombosis detected at 1-month follow-up, with spontaneous recanalization at 3 months. In the latter patient, some residual thrombus was still detected at 6 months. Of the study population of 65 patients, there were 23 deaths. These deaths were not related to the device or the implantation procedure but to the underlying disease process. CONCLUSION This study demonstrates the new nitinol permanent IVC filter to be a safe and an effective device, with a low overall complication rate, for use in patients with thromboembolic disease at high risk of PE.
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Affiliation(s)
- H Rousseau
- Radiology Department, CHU Rangueil, Toulouse, France.
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15
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Abstract
Abstract
Hematologists are often asked to treat patients with venous thromboembolic disease. Although anticoagulation remains the primary therapy for venous thromboembolism, vena caval filters are an important alternative when anticoagulants are contraindicated. To assess the evidence supporting the utility of these devices, a comprehensive review of the English language literature was performed. Except for one randomized trial, the vena caval filter literature consists of case series or consecutive case series. The mean duration of follow-up for each of the 5 filter types varies from 6 to 18 months. All are about equally effective in the prevention of pulmonary embolism (2.6%-3.8%). Deep venous thrombosis (6%-32%) and inferior vena cava thrombosis (3.6%-11.2%) after filter placement vary widely among different filter types primarily because of differences in outcome assessment. Thrombosis at the insertion site is a common complication of filter placement (23%-36%). In view of the absence of randomized comparisons, no filter can be designated as superior in safety or efficacy. Vena caval filters represent a potentially important but poorly evaluated therapeutic modality in the prevention of pulmonary emboli. Randomized trials are necessary to establish the appropriate place for vena caval filters in the treatment of venous thromboembolic disease.
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16
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Abstract
Hematologists are often asked to treat patients with venous thromboembolic disease. Although anticoagulation remains the primary therapy for venous thromboembolism, vena caval filters are an important alternative when anticoagulants are contraindicated. To assess the evidence supporting the utility of these devices, a comprehensive review of the English language literature was performed. Except for one randomized trial, the vena caval filter literature consists of case series or consecutive case series. The mean duration of follow-up for each of the 5 filter types varies from 6 to 18 months. All are about equally effective in the prevention of pulmonary embolism (2.6%-3.8%). Deep venous thrombosis (6%-32%) and inferior vena cava thrombosis (3.6%-11.2%) after filter placement vary widely among different filter types primarily because of differences in outcome assessment. Thrombosis at the insertion site is a common complication of filter placement (23%-36%). In view of the absence of randomized comparisons, no filter can be designated as superior in safety or efficacy. Vena caval filters represent a potentially important but poorly evaluated therapeutic modality in the prevention of pulmonary emboli. Randomized trials are necessary to establish the appropriate place for vena caval filters in the treatment of venous thromboembolic disease.
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Tsubo T, Ebina M, Otomo N, Ishihara H, Matsuki A. Accurate detection of pulmonary embolism using epicardial echocardiography during right nephrectomy in a patient with renal cell carcinoma. J Cardiothorac Vasc Anesth 1998; 12:684-5. [PMID: 9854669 DOI: 10.1016/s1053-0770(98)90244-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- T Tsubo
- Intensive Care Unit, University of Hirosaki School of Medicine, Japan
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Matchett WJ, Jones MP, McFarland DR, Ferris EJ. Suprarenal vena caval filter placement: follow-up of four filter types in 22 patients. J Vasc Interv Radiol 1998; 9:588-93. [PMID: 9684828 DOI: 10.1016/s1051-0443(98)70327-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To determine if suprarenal placement of inferior vena cava (IVC) filters is associated with renal dysfunction or other complications. MATERIALS AND METHODS Case files of all patients with suprarenal vena caval filter placement since 1985 were reviewed for clinical and biochemical evidence of renal dysfunction and renal vein thrombosis. The occurrence of associated complications, including IVC occlusion, filter fracture, device migration, and recurrence of pulmonary embolism was also recorded. RESULTS Twenty-two (2.9%) of 764 IVC filters were implanted above the renal veins: titanium Greenfield filter modified hook (TGF-MH) (n = 16), LGM type I (n = 2), LGM type II (n = 2), and Bird's Nest (BN) type I (n = 2). Reasons for suprarenal filter placement included thrombus to the level of the renal veins (n = 9), failure or poor position of the infrarenal filter (n = 6), pregnancy or intent of pregnancy (n = 4), and the malpositioning of BN filters above the renal veins (n = 2). A single patient demonstrated evidence of transient renal dysfunction. Pulmonary embolus was found at autopsy in one patient. Abdominal radiographs were obtained at follow-up of 18 patients and demonstrated a 2 cm or more migration of the filter in five patients (27.7%). This rate of migration was significantly different from the 3% migration rate reported by the authors' institution in the follow-up of 320 infrarenal IVC filters. There was one filter fracture (5.5%.) and penetration of the IVC occurred in one patient (5.5%). CONCLUSION Follow-up indicates suprarenal IVC filter placement is safe, and no evidence of permanent renal dysfunction after placement was found. Filter migration was the most frequent complication, but no clinical sequelae were noted with these patients.
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Affiliation(s)
- W J Matchett
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock 72205, USA
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Hirota S, Matsumoto S, Ichikawa S, Tomita M, Koshino T, Sako M, Kono M. Suprarenal inferior vena cava filter placement prior to transcatheter arterial embolization (TAE) of a renal cell carcinoma with large renal vein tumor thrombus: prevention of pulmonary tumor emboli after TAE. Cardiovasc Intervent Radiol 1997; 20:139-41. [PMID: 9030506 DOI: 10.1007/s002709900122] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
To prevent embolization of necrotic renal vein tumor after transcatheter embolization of a left renal cell carcinoma, we placed a suprarenal Bird's nest inferior vena cava filter. The patient tolerated the procedure well and had extensive tumor infarction including the tumor thrombus on 6-month follow-up computed tomography.
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Affiliation(s)
- S Hirota
- Department of Radiology, Kobe University School of Medicine, 7-5-2 Kusunoki-cho, Chuoku, Kobe City, 650, Japan
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Gohji K, Morisue K, Okamoto M, Nomi M, Fujii A, Kamidono S. Inferior vena cava filter used for unresectable renal cell carcinoma with tumor thrombi. Int J Urol 1996; 3:504-7. [PMID: 9170583 DOI: 10.1111/j.1442-2042.1996.tb00586.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A titanium Greenfield inferior vena cava filter was used for the treatment of 2 patients with unresectable renal cell carcinomas with tumor thrombi to prevent a fatal pulmonary embolism induced by tumor clots released during systemic interferon therapy and embolization of the primary tumor. After treatment, the size of the renal cell carcinomas at the primary site and the tumor thrombi decreased by 50%. There were no fatal pulmonary embolisms or complications related to the filter during the observation period (24 and 25 months) after therapy. This method may be useful in the prevention of a fatal pulmonary embolism induced by embolization and systemic interferon therapy in these patients.
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Affiliation(s)
- K Gohji
- Department of Urology, Hyogo Medical Center for Adults, Japan
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Affiliation(s)
- D Bergqvist
- Department of Surgery, University Hospital, Uppsala, Sweden
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Gollub MJ, Bosniak MA, Schlossberg P, Chachoua A. Extension of a secondary adrenal neoplasm into the inferior vena cava. ABDOMINAL IMAGING 1994; 19:359-60. [PMID: 8075565 DOI: 10.1007/bf00198199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Adrenal cortical carcinoma is well known to extend into the renal veins and inferior vena cava. It is less known that neoplasms metastatic to the adrenal might also extend into the renal vein and cava. Only a few reports in the literature document this extension. We report a case of metastatic neoplasm to the adrenal extending into the inferior vena cava.
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Affiliation(s)
- M J Gollub
- Department of Radiology, New York University/Tisch Hospital, NY 10016
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Hendricksen D, Eshelman B, Dill L, Frederick R. Unusual etiology for left flank pain in a 29-year-old man. Ann Emerg Med 1993; 22:1455-62. [PMID: 8363120 DOI: 10.1016/s0196-0644(05)81996-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- D Hendricksen
- Department of Emergency Medicine, University of Illinois, College of Medicine, Peoria
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