Long-term follow-up percutaneous vena cava filters: A prospective study in 100 consecutive patients

Abstract

Objectives: the long-term outcome in following insertion of inferior vena cava (IVC) filters remains unclear. Design: prospective study. Material and Methods: one hundred consecutive patients received percutaneous vena cava filters between 1988 and 1993. The patients underwent clinical examination, abdominal X-rays and duplex ultrasound of the IVC, right internal jugular vein and legs after a mean follow-up duration of 38±11 months. Results: forty patients died after implantation (median 11.3 months; IQR: 1.8-20.4 months). The cause of death was known in 33 cases, and pulmonary embolism (PE) was suggested in three. Multivariate analysis revealed the mortality rate to be significantly higher in cancer patients (relative risk of 2.13). The 3-year survival was 20% for cancer patients and 71% for patients without cancer. Among the 60 living patients, thrombi were trapped in the filter in 10 cases, the filter tilted in four, was malpositioned in five and migrated in 29. These incidents were recorded as asymptomatic complications, as opposed to seven IVC thromboses and 23 recurrent lower limb thromboses, which were considered as symptomatic complications. Conclusion: long-term major complications are not frequent. As expected, cancer was the only factor predicting mortality. IVC filters seem effective in preventing PE.