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Clinical outcomes and causes of death in Japanese patients with long-term inferior vena cava filter implants and deep vein thrombosis.

AbstractBACKGROUND AND PURPOSE:
We assessed the causes of death and efficacy of permanent inferior vena cava (IVC) filters for preventing new pulmonary embolisms (PE) in Japanese deep vein thrombosis (DVT) patients with or without PE.
METHODS AND SUBJECTS:
We studied the clinical outcomes during the follow-up period of 1 day to 9 years (median: 18 months; mean: 28 months) in 66 of 72 consecutive patients (44 with acute PE, 27 with intrapelvic DVT, and 1 with floating femoral vein thrombosis). Fifty of 66 patients received anticoagulant therapy after the filter placement.
RESULTS:
Five patients died within 1 month (median 9 days) after the filter placement: three from recurrence of PE, one from cancer, and one from sepsis. Two of the three patients with recurrence of PE had preexisting intracardiac thrombi in the right atrium or main pulmonary artery before filter implantation. Ten patients died from the underlying disease (cancer: 7; brain hemorrhage: 1; amyotrophic lateral sclerosis: 1; pneumonia: 1) over 1 month after the filter placement (median follow-up period: 21 months). No new symptomatic PE recurrence was observed over 1 month after the filter placement. The 61 patients with long-term follow-up had no deterioration of DVT, and all the 31 patients who underwent multi-slice computed tomography showed no PE recurrence or filter thrombus occlusion, fracture, or migration.
CONCLUSIONS:
Underlying diseases and preexisting intracardiac thrombi may be the determining factors for the prognosis of DVT patients. Permanent IVC filters with anticoagulant therapy may be effective for preventing death from new PE in Japanese DVT patients.
AuthorsYumiko Iwamoto, Mitsunori Okamoto, Masaki Hashimoto, Yukihiro Fukuda, Yuko Uchimura, Akimichi Iwamoto, Takeshi Matsumoto, Toshitaka Iwasaki, Hiroki Kinoshita, Hironori Ueda, Yasuki Kihara
JournalJournal of cardiology (J Cardiol) Vol. 64 Issue 4 Pg. 308-11 (Oct 2014) ISSN: 1876-4738 [Electronic] Netherlands
PMID24679943 (Publication Type: Journal Article)
CopyrightCopyright © 2014. Published by Elsevier Ltd.
Chemical References
  • Anticoagulants
Topics
  • Aged
  • Anticoagulants (therapeutic use)
  • Cause of Death
  • Female
  • Humans
  • Japan
  • Male
  • Pulmonary Embolism (prevention & control)
  • Recurrence
  • Vena Cava Filters
  • Venous Thrombosis (complications, therapy)

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