Purpose: To assess the efficacy of temporary vena cava filters in patients
undergoing ultrahigh-dose streptokinase thrombolysis for iliocaval thrombos
is and to determine therapy success and filter and therapy complications.
Methods: Forty-five patients were studied regarding extension and character
istics of thrombosis, duration, success, and complications of thrombolysis
therapy, filter type, access route, pulmonary embolisms, and filter complic
ations.
Results: Complete recanalization was achieved in 57% of cases. Filters were
inserted predominantly via a transbrachial route. One fatal pulmonary embo
lism (2%) occurred 1 day after starting thrombolysis. No other pulmonary em
bolism was noted. Other complications were induced by thrombolysis alone (n
= 12), thrombolysis and filter (n = 9), and filter alone (n = 11).
Conclusion: Fatal pulmonary embolisms as a complication of ultrahigh-dose t
reatment of pelvic or caval thrombosis can not safely be prevented by the t
emporary vena cava filters currently available. Filter design needs to be i
mproved.