Radiology 2000 Jul;216(1):54-6
Inferior vena caval filters: review of a 26-year single-center clinical
experience.
Athanasoulis CA, Kaufman JA, Halpern EF, Waltman AC, Geller SC, Fan CM
Department of Radiology, GRB 290A, Massachusetts General Hospital, 32 Fruit St, Boston, MA
02114, USA. [email protected]
PURPOSE: To review a 26-year single-center clinical experience with inferior vena caval
filters. MATERIALS AND METHODS: During 1973-1998, 1,765 filters were implanted in 1,731
patients. Hospital files were reviewed, and data were collected about the indications,
safety, effectiveness, numbers, and types of caval filters. Fatal post-filter pulmonary
embolism (PE) was considered the primary outcome. Morbidity and mortality were determined
as secondary outcomes. Survival and morbidity-free survival curves were calculated.
RESULTS: The prevalence of observed post-filter PE was 5.6%. It was fatal in 3.7% of
patients. In most patients, fatal PE occurred soon after filter insertion (median, 4.0
days; 95% CI: 2.2, 5.8 days). Major complications occurred in 0.3% of procedures. The
prevalence of observed post-filter caval thrombosis was 2.7%. The 30-day mortality rate
was 17.0% overall, higher among patients with neoplasms (19.5%) as compared with those
without neoplasms (14.3%; P =.004). Filter efficacy and associated morbidity were not
different in 46 patients with suprarenal filters. The rate of filters placed for
prophylaxis was 4.7% overall and increased to 16.4% in 1998. From 1980 to 1996, there was
a fivefold increase in the number of caval filter implants. In recent years, more filters
were implanted in younger patients. CONCLUSION: Inferior vena caval filters provide
protection from life-threatening PE, with minimal morbidity.
PMID: 10887228, UI: 20347952
