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December 23, 2005
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fred usoh, md, Anil Hingorani, M.D., enrico ascher, md, natalie marks, md, richard schutzer, md, manikyam mutyala, md, alexander shiferson, md, william yorkovich, rpa, theresa jacob, Phd.
Maimonides Medical Center, Brooklyn, NY, USA.
Rationale and Objective: The short-term effectiveness and safety placement of SVC filter in the treatment of upper extremity deep venous thrombosis in patients with contraindication to anticoagulation has been well documented. However, as opposed to the numerous reported experiences with IVC filter placement and its complications, there have been no documented long term follow up on SVC filter placement and its potential long term complications. We, therefore, reviewed our experience with SVC filter placement.
Method: A retrospective review of the 154 cases of patients who underwent SVC filter placement between January 1994 and September 2005 at our institution was performed. During this time period, seven additional patients had unsuccessful attempts at SVC filter placement due to widespread deep venous thrombosis and inability to access an adequate vein. The data was evaluated for both insertion complications (pneumothorax, hemorrhage, filter misplacement) and long-term complications (pulmonary embolism, migration, caval occlusion). The follow up included review of serial chest x-rays to evaluate for filter migration in patients who lived a least 60days after filter insertion and had chest X-ray performed (n=61), patients’ charts, clinic visits, and telephone contacts, hospital data bases, city death records and national databases. There were 69 males and 85 females with a mean age of 73.6years (range, 16-96 years ± 15.3 (SD) years). Follow up range from 1day to 3750days (mean = 256.3days ± 576 (SD) days) and 5 patients were lost to follow up
Result: All SVC filters (TrapEase =38, Greenfield =116) were successfully deployed in the 154 patients. During the time periods, 114 (74.0% mortality) of the patients died of chronic illness or from cancer complications. Of the 58 patients who survived more than 2 months, the mean follow-up was 628 days. There were two cases of pericardial tamponade (1%), one case of misplaced filter in innominate vein. There were no known cases of symptomatic pulmonary embolism, caval occlusion, pneumothorax or filter migration
Conclusion: SVC filter placement is associated with a low incidence of complications with long-term follow-up. This data help to reaffirm the safety and effectiveness of SVC filter placement.
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Long Term Follow-up for SVC Filter Placement
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fred usoh, md, Anil Hingorani, M.D., enrico ascher, md, natalie marks, md, richard schutzer, md, manikyam mutyala, md, alexander shiferson, md, william yorkovich, rpa, theresa jacob, Phd.
Maimonides Medical Center, Brooklyn, NY, USA.
Rationale and Objective: The short-term effectiveness and safety placement of SVC filter in the treatment of upper extremity deep venous thrombosis in patients with contraindication to anticoagulation has been well documented. However, as opposed to the numerous reported experiences with IVC filter placement and its complications, there have been no documented long term follow up on SVC filter placement and its potential long term complications. We, therefore, reviewed our experience with SVC filter placement.
Method: A retrospective review of the 154 cases of patients who underwent SVC filter placement between January 1994 and September 2005 at our institution was performed. During this time period, seven additional patients had unsuccessful attempts at SVC filter placement due to widespread deep venous thrombosis and inability to access an adequate vein. The data was evaluated for both insertion complications (pneumothorax, hemorrhage, filter misplacement) and long-term complications (pulmonary embolism, migration, caval occlusion). The follow up included review of serial chest x-rays to evaluate for filter migration in patients who lived a least 60days after filter insertion and had chest X-ray performed (n=61), patients’ charts, clinic visits, and telephone contacts, hospital data bases, city death records and national databases. There were 69 males and 85 females with a mean age of 73.6years (range, 16-96 years ± 15.3 (SD) years). Follow up range from 1day to 3750days (mean = 256.3days ± 576 (SD) days) and 5 patients were lost to follow up
Result: All SVC filters (TrapEase =38, Greenfield =116) were successfully deployed in the 154 patients. During the time periods, 114 (74.0% mortality) of the patients died of chronic illness or from cancer complications. Of the 58 patients who survived more than 2 months, the mean follow-up was 628 days. There were two cases of pericardial tamponade (1%), one case of misplaced filter in innominate vein. There were no known cases of symptomatic pulmonary embolism, caval occlusion, pneumothorax or filter migration
Conclusion: SVC filter placement is associated with a low incidence of complications with long-term follow-up. This data help to reaffirm the safety and effectiveness of SVC filter placement.
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