vena cava filter


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Vena Cava Filter

 

Definition

A vena cava filter is a device inserted into a major vein to prevent a blood clot from entering the lungs.

Purpose

The purpose of a vena cava filter is to prevent a blood clot from potentially traveling to the lungs. A thrombus clot traveling to the lungs is called a pulmonary embolism (PE). A thrombus in the deep venous system (the part of the circulation that brings blood back to the heart) represents a disorder of normal hemostasis (the normal clotting of blood).
Insertion of a vena cava filter is indicated for patients who:
  • cannot receive medications that can dissolve the clot (anticoagulation therapy)
  • have a thrombus in a deeply situated vein
  • experiance complication of anticoagulation therapy such as bleeding
  • experiance failure of anticoagulation therapy to prevent pulmonary embolism
  • have an embolus in the lungs (pulmonary embolectomy) removed
  • have a recurrent embolism while receiving adequate medications
  • have significant bleeding complications during anticoagulation

Precautions

There are no significant precautions concerning insertion of a vena cava filter. The devices are usually effective and short-term complications are unusual

Description

Vena cava filters are usually inserted in to prevent PE caused by a thrombosis in a deep vein (DVT). Approximately 60% of patients who die in a hospital have evidence of PE during autopsy. The incidence (number of new cases) of DVT is highest for patients undergoing surgical repair of a fractured hip. However, DVT is common in both surgical and medical patients. DVT is found in 29-33% of patients in medical intensive care units (MICU) and in 27-40% of patients with a heart attack (myocardial infarction). Vena cava filters are placed to prevent thrombi from entering the lungs. There is currently a new type of filter called the Kim-Ray-Greenfield filter.

Preparation

Insertion of a vena cava filter is an invasive procedure. The patient is prepared for this procedure using standard surgical protocols. The VCF is commonly implanted in the jugular vein in the neck or the femoral vein in the groin. The procedure is generally well tolerated.

Aftercare

This depends on the patient's health status and recommendation's for continued care.

Risks

Many patients have died from PE even with a vena cava implantation. Use of a VCF is primarily indicated if there are contraindications for anticoagulation therapy. VCF can increase a patient's susceptibility for developing recurrent DVT.

Normal results

Patient progresses well and prevention of large emboli that can cause a PE is successful.

Abnormal results

The desired effect is not accomplished and the patient develops a PE resulting in death.

Key terms

Embolus — An embolus (or emboli the plural form) is a blood clot that has detached from its site of origin and travels to the lungs (pulmonary artery), where it can rupture the artery, causing death.
Pulmonary embolism — A traveling thrombus that has lodged in the pulmonary artery.
Thrombus — A thrombus (or thrombi the plural form) is a blood clot that can form in a deeply situated vein.

Resources

Books

Bone, Roger C. Pulmonary & Critical Care Medicine. Mosby-Year Book, Inc., 2000.
Braunwald, Eugene, et al, editors. Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. W. B. Saunders Company, 2001.
Goldman, Lee, et al, editors. Cecil Textbook of Medicine. 21st ed. W. B. Saunders Company, 2000.
Rakel, Robert E., et al, editors. Conn's Current Therapy. 53rd ed. W. B. Saunders Company, 2001.
Townsend, Courtney M. Sabiston Textbook of Surgery. 16th ed. W. B. Saunders Company, 2001.

Periodicals

Isnard, R., and M. Komajda. "Thromboembolism in Heart Failure, Old Ideas and New Challenges." European Journal of Heart Failure June 2001.

Organizations

American College of Angiology. 295 Northern Blvd., Ste. 104 Great Neck, NY 11021-4701.

filter

 [fil´ter]
1. a device for eliminating or separating certain elements, as (a) particles of certain size from a solution, or (b) rays of certain wavelength from a stream of radiant energy.
2. to cause such separation or elimination.
membrane filter a filter made up of a thin film of collodion, cellulose acetate, or other material, available in a wide range of defined pore sizes, the smaller ones being capable of retaining all the known viruses.
Millipore filter trademark for a device used to filter nutrient solutions as they are administered intravenously.
vena cava filter (vena caval filter) a filter used in the inferior vena cava to prevent pulmonary embolism.
Wood's filter a nickel-oxide filter that holds back all but a few violet rays and passes ultraviolet rays of about 365 nm; see also Wood's light.

ve·na ca·va fil·ter

a filter used for interruption of inferior vena cava to prevent pulmonary embolism; for example, Greenfield filter.
Synonym(s): venocaval filter

vena cava filter

Cardiovascular disease A device implanted within veins, usually leg veins, that are at high risk of developing DVT and thromboembolism. See Deep vein thrombosis, Greenfield filter, Pulmonary thromboemboloism.
References in periodicals archive ?
Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC (Prevention du Risque d'Embolie Pulmonaire par Interruption Cave) randomized study.
Initial experience in humans with a new retrievable inferior vena cava filter.
Early experience with the retrievable OptEase vena cava filter in high-risk trauma patients.
The safety of retrievable vena cava filter deployment and retrieval has been demonstrated by numerous studies, but there is a paucity of evidence regarding the long-term safety or efficacy of these devices.
The Crux Vena Cava Filter from Crux Biomedical (Photo: Business Wire)
Crux Biomedical announced that a recently completed pivotal trial of its innovative Crux Vena Cava Filter (VCF) System with bi-directional retrieval was presented at the 2012 Society of Interventional Radiology (SIR) Annual Scientific Meeting (March 24-29, San Francisco).
Keywords: peripheral vascular stents, percutaneous transluminal angioplasty (PTA) balloon catheters, embolic protection devices, inferior vena cava filters, stent-grafts, surgical grafts, interventional catheters, hydrophilic guidewires, introducer sheaths, diagnostic catheters and guidewires, vascular closure devices
Global Markets Direct's "Inferior Vena Cava Filter Clinical Trials Analysis" is an essential source of data and information pertaining to product clinical trials being carried out by Inferior Vena Cava Filter manufacturers, globally.
Phase One Medical is initially utilizing both technology platforms in development of two highly differentiated removable vena cava filter systems for the prevention of Pulmonary Embolism (PE) resulting from Deep Vein Thrombosis (DVT).
The report provides procedure volumes within market segments - Aortic Open Repair Procedures, Aortic Stent Graft Procedures, Carotid Artery Embolic Protection Procedures, Deep Seated Artery Stenting Procedures, Inferior Vena Cava Filters (IVCF) Procedures, Lower Extremity Embolic Protection Procedures, Percutaneous Transluminal Angioplasty (PTA) Balloon Procedures, Peripheral Angiography Procedures, Peripheral Vascular Stenting Procedures, PTA Drug Eluting Balloon (DEB) Procedures, Renal Artery Embolic Protection Procedures and Vascular Grafts Procedures.