Abstract 15485: Duration of Temporary Inferior Vena Cava Filter for Acute Pulmonary Embolism
Background: Temporary inferior vena cava filters (t-IVCF) may be effective for the prevention of recurrent acute pulmonary embolism (APE). However there is no consensus regarding how long we should implant the t-IVCF.
Methods: Patients with APE who underwent t-IVCF insertion from January 2000 to March 2009 were enrolled in this study and were followed up for 2 years. At April 2005 the treatment protocol was changed regarding the duration of t-IVCF insertion. Before April 2005, the t-IVCF was inserted for at least 7 days and after improvement of echocardiographic right ventricular strain was confirmed before extraction. In the latter period, the t-IVCF was extracted as soon as possible just after echocardiographic right ventricular strain was confirmed. The primary outcome was all cause death after two years follow up for the two protocols. Complications due to t-IVCF insertion were also compared between the two protocols.
Results: The mean follow up period was 721 days for the old protocol (41 patients) and 706 days for the new protocol (40 patients). There were no differences of age and gender at the time of admission. All patients were alive at the time of discharge. The survival rate at the time of 2 years follow up for each protocol was 87.8% and 90.0%, respectively (p=n.s.). At the time of 2 years follow up, there were no differences for death caused by APE, recurrence of pulmonary embolism and deep vein thrombosis, bleeding complications and rate of permanent filter implantation between the two protocols. The median duration of t-IVCF insertion was 15 days in the old protocol and 5 days in the new protocol (p<0.01). The composite rate of complications during t-IVCF insertion (thrombus formation, flow disruption of the filter site due to thrombus, dislocation and catheter related infection) was significantly higher among patients with the old protocol (56.1% vs 17.5%, p<0.01).
Conclusion: With our new protocol for the management of APE using t-IVCFs, we could shorten the duration of t-IVCF and reduce the rate of complications during insertion without worsening the short and long term prognosis.
- © 2011 by American Heart Association, Inc.