LGM (VENA-TECH) VENA-CAVAL FILTER - EXPERIENCE AT A SINGLE INSTITUTION

PURPOSE: The authors describe their experience with LG-Medical (LGM [V ena Tech]) filter placement and follow-up. PATIENTS AND METHODS: LGM v ena cava filters were placed in 63 patients. Follow-up was obtained by means of duplex sonography of the introduction vein and inferior vena cava (IVC) and abdominal radiography in 50 patients, and by means of autopsy in an additional four patients. In eight, only clinical follow -up was obtained and one patient was lost to follow-up. RESULTS: Major complications of placement occurred in three patients, all when the r ight internal jugular vein was used for introduction: In one patient a filter was inadvertently placed in the right renal vein and in two th e filter failed to open fully. No serious complications of placement o ccurred when either the right or left common femoral veins were used. Pulmonary embolism (PE) recurred in four patients (6%) and was fatal i n one. Septicemia from an infected filter was the probable cause of de ath in another patient. Introduction vein thrombosis occurred in five patients (8%) and was symptomatic in two (3%). Occlusion of the IVC oc curred in 15 patients (24% of the total patient group, but 28% of thos e with objective follow-up) and was symptomatic in 12 (19%). Two patie nts with IVC occlusion had recurrent PE. CONCLUSION: These data sugges t that the rate of IVC occlusion is higher than most previous reports have suggested and that IVC occlusion may be a potentially serious com plication.