THE GUNTHER TEMPORARY INFERIOR VENA-CAVA FILTER FOR SHORT-TERM PROTECTION AGAINST PULMONARY-EMBOLISM

Purpose: To evaluate clinically the Gunther temporary inferior vena ca va (NC) filter. Methods: Eleven IVC filters were placed in 10 patients . Indications for filter placement were surgical pulmonary embolectomy in seven patients, pulmonary embolism in two patients, and free-float ing iliofemoral thrombus in one patient. Eight filters were inserted f rom the right femoral approach, three filters from the left, Follow-up was by plain abdominal radiographs, cavography, and duplex ultrasound (US). Eight patients received systemic heparinization. Follow-up, dur ing 4-60 months after filter removal was by clinical assessment, and i maging of the lungs was performed when pulmonary embolism (PE) was sus pected. Patients received anticoagulation therapy for at least 6 month s. Results: Ten filters were removed without complications 7-14 days ( mean 10 days) after placement. One restless patient pulled the filter back into the common femoral vein, and a permanent filter was placed. In two patients a permanent filter was placed prior to removal. One pa tient developed sepsis, and one an infection at the insertion site. Cl inically no recurrent PE developed with the filter in place or during removal. One patient had recurrent PE 7 months after filter removal. C onclusion: The Gunther temporary IVC filter can be safely placed for s hort-term protection against PE. The use of this filter is not appropr iate in agitated or immunocompromised patients.