PERCUTANEOUS IMPLANTATION OF PERMANENT VENA-CAVAL FILTERS - FOLLOW-UPOF 117 CONSECUTIVE PATIENTS

Purpose: Retrospective review of indication, insertion technique and p roblems, complications and effectiveness of 5 different filter designs implanted during a period of 5 years. Materials, patients and methods : We inserted one Filcard-filter, 4 Antheor DC 3 perm.-filters, 17 Tri gon/Cardial-filters, 28 Titan-Greenfield-filters (modified hook) and 6 5 LGM 30 D/U Vena Tech-filters via a femoral (n = 111) or a jugular (n = 4) approach in 115 of 117 patients. Indication was acute deep throm bosis of the iliac or femoral vein with and without pulmonary embolism (PE) in patients with contraindication to, or unsuccessful, anticoagu lation therapy or lysis. Follow-up was possible in 92 patients. Result s: In two of 117 patients the filter could not be implanted due to dis section of the left iliac vein. In the other 115 patients we achieved an orthograde position of the filter in 78%, 22% of the filters tilted more than 15 degrees and 25% had been opened incompletely. We noticed late filter dislocation in 4 cases, deep vein thrombosis of the acces s vein in two cases, one haematoma of the insertion site, three asympt omatic perforations of filter struts through the caval wall, 14 filter induced thromboses of the vena cava (15.2%) and 13 recurrent PE (14.1 %), fatal in 5 cases (5.4%). Conclusion: The implantation of vena cava l filters as a prophylaxis of PE is easy and of low risk. Because of t he relatively high rate of recurrent PE (14.1%) in our series after im plantation, the effectivity must be judged critically.