Inferior vena cava filters for HIV infected patients with pulmonary embolism and contraindications to anticoagulation

Objectives: To describe the mode of presentation, interventions, and outcom e of HIV infected patients with pulmonary embolism and a contraindication t o anticoagulation, who were treated with a bird's nest filter. Methods: Retrospective review of case records and imaging department databa se at: UCL Hospitals, London, UK. Results: Three patients had pulmonary embolism and contraindications to ant icoagulation. Contraindications were concomitant intracerebral pathology in two patients (one also had bleeding from gastric Kaposi's sarcoma and the other was cognitively impaired with HIV associated dementia complex) and al cohol induced liver disease/binge drinking in the third patient. Anticoagul ation was avoided by introducing a bird's nest filter into the inferior ven a cava via the common femoral vein. During follow up (7, 8, and 21 months) no complications or recurrent pulmonary emboli occurred. Conclusion: The bird's nest inferior vena cava filter has a role in prevent ing further pulmonary emboli in HIV infected patients with contraindication s to anticoagulation.