PARTIAL INTERRUPTION OF THE INFERIOR VENA-CAVA - 10-YEAR EVOLUTION INPROTOCOLS AT GRENOBLE-UNIVERSAL-HOSPITAL - STUDY OF 621 PATIENTS

An evolution in protocols regarding indications and modalities for Par tial Interruption of the Inferior Vena Cava (PIIVC) on 621 patients at Grenoble University Hospital is reported and the influence of new met hods in diagnosis (vascular sonography) and therapy (percutaneous filt ers) is assessed. This comparative study covers the intervals from 198 2-1984 (Period A - 333 patients), and 1989-1991 (Period B - 288 patien ts). The percentage of patients with venous thromboembolic disease who underwent PIIVC clearly decreased (21.8% in period A vs. 13% in perio d B, p < 0.01). The incidence of what are currently miscalled ''prophy lactic'' but are in fact adjunctive indications also diminished (115 p atients in period A, or 34.5% of the PIIVC cases vs. 60 patients in pe riod B, or 20.8% of the PIIVC cases, p < 0.05). There was a reduction in the use of Miles caval clips (59 patients or 17.7% for period A vs. 34 patients or 11.8% for period B, p < 0.05). Although there has been an increase in the use of percutaneous caval filters, the use of perc utaneous filters has not lead to an increase in the real rate of PIIVC performed by an Angiology Unit with a large experience in the diagnos is and follow-up of patients with venous thromboembolic disease.