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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 5, 662-667.
doi: 10.1302/0301-620X.90B5.19743  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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The use of retrievable inferior vena cava filters in orthopaedic patients

E. J. Strauss, MD, Orthopaedic Surgery Resident1; K. A. Egol, MD, Associate Professor, Vice Chairman for Education1; M. Alaia, MD, Orthopaedic Surgery Resident1; D. Hansen, NP, Nurse Practitioner2; M. Bashar, MD, Clinical Instructor2; and D. Steiger, MD, Associate Professor2

1 Department of Orthopaedic Surgery
2 Department of Medicine New York University Hospital for Joint Diseases, 301 East 17th Street, New York, New York 10003, United States.

Correspondence should be sent to Professor D. Steiger; e-mail: bdsteiger{at}optonline.net

This study was undertaken to evaluate the safety and efficacy of retrievable inferior vena cava filters in high-risk orthopaedic patients. A total of 58 patients had a retrievable inferior vena cava filter placed as an adjunct to chemical and mechanical prophylaxis, most commonly for a history of previous deep-vein thrombosis or pulmonary embolism, polytrauma, or expected prolonged immobilisation. In total 56 patients (96.6%) had an uncomplicated post-operative course. Two patients (3.4%) died in the peri-operative period for unrelated reasons.

Of the 56 surviving patients, 50 (89%) were available for follow-up. A total of 32 filters (64%) were removed without complication at a mean of 37.8 days (4 to 238) after placement. There were four filters (8%) which were retained because of thrombosis at the filter site, and four (8%) were retained because of incorporation of the filter into the wall of the inferior vena cava. In ten cases (20%) the retrievable filter was left in place to continue as primary prophylaxis. No patient had post-removal thromboembolic complications.

A retrievable inferior vena cava filter, as an adjunct to chemical and mechanical prophylaxis, was a safe and effective means of reducing the acute risk of pulmonary embolism in this high-risk group of patients. Although most filters were removed without complications, thereby avoiding the long-term complications that have plagued permanent indwelling filters, a relatively high percentage of filters had to be left in situ.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General