The use of optional inferior vena cava filters of type Optease in trauma patients--a single type of filter in a single Medical Center.

BACKGROUND

Venous thromboembolism (VTE) is a frequent complication of patients who experienced major trauma. Prevention of VTE is usually by thrombophylaxis and or by the use of a retrievable filter. Lately, the use of a retrievable filter in trauma patients has increased despite evidence cautioning against its use.

AIMS: To evaluate complications related to a single type of filter prophylactically used in a tertiary trauma center and search for risk factors that may preclude filter retrieval

METHODS

142 patients aged 16 through 60 who experienced a major trauma and were treated with a prophylactic IVC filter of type optease were evaluated.

RESULTS

The median time from trauma to filter insertion was 2days and low molecular weight heparin at prophylactic dose was initiated in 92% once the filter was inserted. Nine patients developed IVC thrombosis and one of them died despite the use of thrombolytic therapy. Another 8 patients developed lower extremities deep vein thrombosis. The filter was left in place in 13 more patients after attempted filter removal was unsuccessful. Among patients with successful removal, the median dwelling time was 30days. There was no relationship between successful removal and age, sex, BMI, Glasgow coma scale, or injury severity score of patients when first evaluated.

CONCLUSIONS

Of concern is the persistent complications related to IVC filter even with the prophylactic use of anticoagulants and the dose of radiation trauma patients were exposed during insertion and retrieval of filter. Thus, the routine use of IVC filter in trauma patients may not be desirable.