Temporary vena cava filters and ultrahigh streptokinase thrombolysis therapy: a clinical study.

PURPOSE: To assess the efficacy of temporary vena cava filters in patients undergoing ultrahigh-dose streptokinase thrombolysis for iliocaval thrombosis and to determine therapy success and filter and therapy complications.

METHODS

Forty-five patients were studied regarding extension and characteristics of thrombosis, duration, success, and complications of thrombolysis therapy, filter type, access route, pulmonary embolisms, and filter complications.

RESULTS

Complete recanalization was achieved in 57% of cases. Filters were inserted predominantly via a transbrachial route. One fatal pulmonary embolism (2%) occurred 1 day after starting thrombolysis. No other pulmonary embolism 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 treatment of pelvic or caval thrombosis can not safely be prevented by the temporary vena cava filters currently available. Filter design needs to be improved.