Vascular Specialist International

The Korean Society for Vascular Surgery (대한혈관외과학회)
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Clinical Outcomes of a Preoperative Inferior Vena Cava Filter in Acute Venous Thromboembolism Patients Undergoing Abdominal-Pelvic Cancer or Orthopedic Surgery

  • Kim, Hakyoung (Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Han, Youngjin (Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ko, Gi-Young (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jeong, Min-Jae (Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Kyunghak (Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Cho, Yong-Pil (Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kwon, Tae-Won (Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2018.09.01
  • Accepted : 2018.10.26
  • Published : 2018.12.31
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Abstract

Purpose: Surgery is the most common risk factor for pulmonary embolism (PE) in patients with a recent venous thromboembolism (VTE). This study reviewed clinical outcomes of preoperative inferior vena cava filter (IVCF) use in patients with acute VTE during abdominal-pelvic cancer or lower extremity orthopedic surgeries. Materials and Methods: We retrospectively analyzed 122 patients with a recent VTE who underwent IVCF replacement prior to abdominal-pelvic cancer or lower extremity orthopedic surgery conducted between January 2010 and December 2016. Demographics, clinical characteristics, postoperative IVCF status, risk factors for a captured thrombus, and clinical outcomes were collected for these subjects. Results: Among the 122 study patients who were diagnosed with acute VTE in the prior 3 months and underwent preoperative IVCF replacement, 70 patients (57.4%) received abdominal-pelvic cancer surgery and 52 (42.6%) underwent lower extremity orthopedic surgery. There were no perioperative complications associated with IVCF in the study population and no cases of symptomatic PE postoperatively. A captured thrombus in the filter was identified postoperatively in 16 patients (13.1%). Logistic regression analysis indicated that postoperative anticoagulation within 48 hours significantly reduced the risk of a captured thrombus (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.08-0.94; P=0.032). Conclusion: A captured thrombus in preoperative IVCF was identified postoperatively in 16 patients (13.1%). Postoperative anticoagulation within 48 hours reduces the risk of captured thrombus in these cases.

Keywords

References

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  1. Clinical outcomes of comorbid cancer patients with venous thromboembolism : A retrospective, single-center study in Korea vol.98, pp.37, 2018, https://doi.org/10.1097/md.0000000000017181