Inferior vena cava filters for HIV infected patients with pulmonary embolism and contraindications to anticoagulation

Abstract

Objectives: To describe the mode of presentation, interventions, and outcome of HIV infected patients with pulmonary embolism and a contraindication to anticoagulation, who were treated with a bird's nest filter. Methods: Retrospective review of case records and imaging department database at UCL Hospitals, London, UK. Results: Three patients had pulmonary embolism and contraindications to anticoagulation. Contraindications were concomitant intracerebral pathology in two patients (one also had bleeding from gastric Kaposi's sarcoma and the other was cognitively impaired with HIV associated dementia complex) and alcohol induced liver disease/binge drinking in the third patient. Anticoagulation was avoided by introducing a bird's nest filter into the inferior vena cava via the common femoral vein. During follow up (7, 8, and 21 months) no complications or recurrent pulmonary emboli occurred. Conclusion: The bird's nest inferior vena cava filter has a role in preventing further pulmonary emboli in HIV infected patients with contraindications to anticoagulation.