[Temporary cava filter: effective prophylaxis of pulmonary embolism in venous thrombosis in the region of the pelvic vascular system and the inferior vena cava?].

PURPOSE

To assess the temporary Günther filter system concerning handling, complication rate and efficacy in respect to prophylaxis of pulmonary embolism.

PATIENTS AND METHODS

45 temporary Günther filters were placed in 44 patients (mean age 46 years) with deep venous thrombosis of the iliac and/or inferior vena cava.

RESULTS

The mean time until filter retrieval was 6.1 +/- 4.1 days (maximum 14 days) dependent on the success of either thrombolytic therapy or thrombus consolidation. 27 patients underwent systemic thrombolytic therapy (61%), three patients (7%) received local thrombolysis. 14 patients (32%) were treated with heparin in a therapeutic dosage (PTT > 60 sec). We observed four complications (8.8%): one accidental arterial puncture (carotid artery on attempting an internal jugular vein approach), one infection located at the puncture site and one caval vein thrombosis in a patient with known heparin-associated thrombocytopenia. One patient died of pulmonary embolism despite correct filter positioning.

CONCLUSION

Percutaneous placement of inferior vena cava filters is therefore an easy, safe and effective prophylaxis in respect of pulmonary embolism if combined with thrombolytic therapy or therapeutic heparinisation.