PERCUTANEOUS INFERIOR VENA-CAVAL FILTERS - FOLLOW-UP OF 7 DESIGNS IN 320 PATIENTS

Three hundred twenty-four percutaneous inferior vena caval (IVC) filte rs of different designs were placed in 320 patients from April 1985 th rough June 1992. No acute mortality or substantial morbidity was attri buted to filter placement. Radiologic or pathologic follow-up data wer e obtained in 227 (71%) patients (230 filters); clinical follow-up dat a only were obtained in 50 (16%) patients (50 filters). One hundred tw enty (43%) patients died; post-filter-placement pulmonary emboli (PE) were related to the cause of death in eight. At IVC filter imaging stu dies, 26 of 137 (19%) filters demonstrated caval thrombus; 12 of 132 ( 9%) filters had delayed penetration through the IVC wall of greater th an 3 mm; 13 of 230 (6%) filters migrated more than 1 cm; and five of 2 30 (2%) filters had fracture of a strut or leg. Deep venous thrombosis (DVT) at the insertion puncture site or in the lower extremity was no ted in 26 of 117 (22%) cases of filter placement. Among patients witho ut imaging studies, clinical suspicion of complications included PE in four patients, IVC thrombus in 14 patients, and lower-extremity DVT i n 10 patients. Long-term clinical and radiologic follow-up of all IVC filters is indicated due to the relatively high prevalence of some com plications.