Clinical Application Of Inferior Vena Cava Filter In Preventing Pulmonary Embolism And Investigation For Choosing Types Of Inferior Vena Cava Filter

Objective To evaluate the effect of implanting inferior vena cava filter ( VCF) to prevent pulmonary embolism due to detachment of thrombus in deep vein of lower extremities and the choices of the types about VCFMethods Retrospective analysis was underwent about 90 patients with acute iliofemoral thrombosis and 2 patients with pulmonary embolism (PE) who needs interventional theraphy in the First Affiliated Hospital of Suzhou University from 2007 to 2010 , of which 48 cases were female, male 44 cases, aged 18 to 84 years old, average 60.25 years, All 90 patients were diagnosised as lower extremity deep vein thrombosis underwent Doppler ultrasonography and D-dimer, and revealed no PE formation by X- ray or CT examination. Two cases were diagnosised as PE by X -ray and CT examatiom, who have the symptoms of chest pain, chest tightness and other clinical manifestations. VCFs were successfully implanted through the femoral venous access, including 38 permanent VCF and 62 Retrievable VCF,of which 14 cases were used Venatech Filter (LP-VTF), 24 cases Trap Ease Filter (TEF), 9 cases Aegisy Filter, 43 casea OptEase Filter (OEF), 2 cases Gunther Tulip Filter (GTF).The cases whose VCFS were retrieable should be taked out as much as possible after thrombus were dissolutied.All the cases whose VCFs were not trievable were followed up for 3 to 36 monthes , mainly by chest and abdominal CT, ultrasound, or the inferior vena cava imaging。Results The vena cava filters were successfully implanted in all cases . one case of PE died of pulmonary embolism again.30 recoverable filters were taked out successfully after placing for 10 to 15 days,24 cases of the VCFs covered with a small amount of thrombus on surface. The diameters of the thrombus are about 0.1-0.5cm.There were no complications such as recurrent deep venous thrombosis or pulmonary embolism or other significant incidece occurred in 61 un-trievable cases.Conclusion Inferior vena cava filter's placement is an relatively effective and safe technique for preventing PE ,although there was an recurent PE after the protection of VCF. Simultaneously we should grasp the indication of the implantation of inferior vena cava filters.It is necessary to further investigate how to choose the ideal types of the VCF.