THE USE OF INFERIOR VENA-CAVA FILTERS IN PEDIATRIC-PATIENTS FOR PULMONARY EMBOLUS PROPHYLAXIS

Purpose: To report our experience with inferior vena cava (IVC) filter s in pediatric patients. Methods: Over a 19-month period, eight low-pr ofile percutaneously introducible IVC filters were placed in four male and four female patients aged 6-16 years (mean 11 years). Indications were contraindication to heparin in six patients, anticoagulation fai lure in one, and idiopathic infrarenal IVC thrombosis in one. Six of t he eight devices placed were titanium Greenfield filters. One LGM and one Bird's Nest filter were also placed. Two of the filters were intro duced via the right internal jugular vein by cutdown, and the remainde r were placed percutaneously via the right internal jugular vein or th e right common femoral vein. Patients received follow-up abdominal rad iographs from 2 to 13 months after IVC filter placement. Results: All filters were inserted successfully without complication. Three of the patients died during the follow-up period: two due to underlying brain tumors at 2 and 12 months and a third at 6 weeks due to progressive i diopathic renal vein and IVC thrombosis. The remaining five patients w ere all alive and well at follow-up without evidence of IVC thrombosis , pulmonary emboli, or filter migration. Conclusion: IVC filter placem ent using available devices for percutaneous delivery is technically f easible, safe, and effective in children.