Experience with a potentially temporary cava filter in patients with multiple injuries

Introduction: In Europe, there is little experience in the application of t emporary cava filters in patients with multiple injuries. Especially patien ts with pelvic injuries, fractures of the spine, and the lower extremities are at high risk for thromboembolic events like thrombosis or pulmonary emb oli. Moreover, in patients with severe head injuries, anticoagulation is co ntraindicated. Method: We present in this paper our experience with 24 cons ecutive patients with multiple injuries who were treated with a temporary c ava filter. The insertion site was either the femoral (n = 20) or the jugul ar (n = 4) vein. The 24 patients revealed a mean ISS of 35.1 +/- 2.01 point s. Nineteen patients had pelvic injuries and 17 patients suffered from seve re head injury. In 17 patients the insertion of the filter was prophylactic , in 4 patients a thrombosis was present and in 3 patients a non-fatal pulm onary emboli was diagnosed before the application of a cava filter. Results : No complication occurred due to insertion of the filter. In one patient a thrombosis of the cava was observed as the only overall complication (1 of 24 = 4.2%). Conclusion: The insertion of a cava filter in patients with mu ltiple injuries with contraindication for anticoagulation is a safe and eff ective procedure to prevent fatal pulmonary emboli.