Clinical Outcomes of a Preoperative Inferior Vena Cava Filter in Acute Venous Thromboembolism Patients Undergoing Abdominal-Pelvic Cancer or Orthopedic Surgery
10.5758/vsi.2018.34.4.103
- Author:
Hakyoung KIM
1
;
Youngjin HAN
;
Gi Young KO
;
Min Jae JEONG
;
Kyunghak CHOI
;
Yong Pil CHO
;
Tae Won KWON
Author Information
1. Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. medjin00@gmail.com
- Publication Type:Original Article
- Keywords:
Venous thromboembolism;
Inferior vena cava filter;
Pulmonary embolism;
Surgery
- MeSH:
Demography;
Humans;
Logistic Models;
Lower Extremity;
Orthopedics;
Pulmonary Embolism;
Retrospective Studies;
Risk Factors;
Thrombosis;
Vena Cava Filters;
Vena Cava, Inferior;
Venous Thromboembolism
- From:Vascular Specialist International
2018;34(4):103-108
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Surgery is the most common risk factor for pulmonary embolism (PE) in patients with a recent venous thromboembolism (VTE). This study reviewed clinical outcomes of preoperative inferior vena cava filter (IVCF) use in patients with acute VTE during abdominal-pelvic cancer or lower extremity orthopedic surgeries. MATERIALS AND METHODS: We retrospectively analyzed 122 patients with a recent VTE who underwent IVCF replacement prior to abdominal-pelvic cancer or lower extremity orthopedic surgery conducted between January 2010 and December 2016. Demographics, clinical characteristics, postoperative IVCF status, risk factors for a captured thrombus, and clinical outcomes were collected for these subjects. RESULTS: Among the 122 study patients who were diagnosed with acute VTE in the prior 3 months and underwent preoperative IVCF replacement, 70 patients (57.4%) received abdominal-pelvic cancer surgery and 52 (42.6%) underwent lower extremity orthopedic surgery. There were no perioperative complications associated with IVCF in the study population and no cases of symptomatic PE postoperatively. A captured thrombus in the filter was identified postoperatively in 16 patients (13.1%). Logistic regression analysis indicated that postoperative anticoagulation within 48 hours significantly reduced the risk of a captured thrombus (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.08–0.94; P=0.032). CONCLUSION: A captured thrombus in preoperative IVCF was identified postoperatively in 16 patients (13.1%). Postoperative anticoagulation within 48 hours reduces the risk of captured thrombus in these cases.
