Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
J Surg Oncol. 2024 Aug;130(2):257-264. doi: 10.1002/jso.27734. Epub 2024 Jun 12.
This study evaluated the utilization and outcomes of inferior vena cava (IVC) filters as thromboprophylaxis in cancer patients undergoing surgery.
This single-center retrospective study analyzed baseline patient characteristics and clinical outcomes of surgical cancer patients who received perioperative prophylactic IVC filters. Primary clinical endpoints included venous thromboembolism (VTE) incidence and filter complications. A statistical correlative analysis was conducted to identify risk factors related to pulmonary embolism (PE), deep vein thrombosis (DVT), and filter thrombi, as well as advanced technique filter removal and mortality at 6 months.
A total of 252 surgical oncology patients (median age, 59; female 51%) received IVC filters for the perioperative prevention of PE. Primary surgical sites included spine (n = 91, 36%), orthopedic extremity/joint (n = 49, 19%), genitourinary (n = 47, 19%), brain/cranial (n = 40, 16%), abdominal (n = 18, 7%), multisite (n = 4, 2%), and chest (n = 3, 1%). Moreover, 15% of patients experienced DVTs in the postplacement preretrieval period, while 2% (n = 6) of patients experienced definitive PEs. A total of 36% of IVC filters were ultimately retrieved, with an average filter dwell time of 7.4 months. Complications occurred in one retrieval.
Prophylactic perioperative IVC filters in surgical cancer patients resulted in minimal complications while ultimately resulting in a low incidence of PE.
本研究评估了下腔静脉（IVC）滤器作为癌症手术患者血栓预防的应用和效果。
本单中心回顾性研究分析了接受围手术期预防性 IVC 滤器的手术癌症患者的基线患者特征和临床结局。主要临床终点包括静脉血栓栓塞症（VTE）发生率和滤器并发症。进行了统计相关性分析，以确定与肺栓塞（PE）、深静脉血栓形成（DVT）和滤器血栓形成相关的风险因素，以及 6 个月时的高级技术滤器取出和死亡率。
共有 252 例接受手术治疗的肿瘤患者（中位年龄 59 岁，女性 51%）接受了 IVC 滤器以预防围手术期的 PE。主要手术部位包括脊柱（n=91，36%）、骨科四肢/关节（n=49，19%）、泌尿生殖系统（n=47，19%）、脑/颅（n=40，16%）、腹部（n=18，7%）、多部位（n=4，2%）和胸部（n=3，1%）。此外，15%的患者在取出前的放置后时期发生了 DVT，而 2%（n=6）的患者发生了明确的 PE。最终有 36%的 IVC 滤器被取出，平均滤器留置时间为 7.4 个月。在取出过程中发生了 1 例并发症。
在手术癌症患者中预防性应用围手术期 IVC 滤器可导致最小的并发症，同时最终导致 PE 的发生率较低。
