Effectiveness of inferior vena cava filters without anticoagulation therapy for prophylaxis of recurrent pulmonary embolism_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WANG Baofeng ¹ , GUAN Min ² ,  ZHANG Chunfeng ¹

1. Department of Respiratory Medicine, Central Hospital of Baoji, Baoji, Shanxi 721008, P.R.China;
2. Department of Infectious Diseases, Central Hospital of Baoji, Baoji, Shanxi 721008, P.R.China;

Corresponding?author：

ZHANG Chunfeng, Email: 13377074@qq.com

Keywords：

Inferior vena cava filter; Anticoagulation; Prevention; Recurrent pulmonary embolism

DOI：

10.7507/1671-6205.201612011

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Objective To explorer the application value of the inferior vena cava filter (IVCF) implantation in the prevention of recurrent pulmonary embolism (PE). Methods Clinical data of 265 inpatients with PE admitted from November 2014 to November 2016 were retrospectively analyzed. The patients were divided into an IVCF treatment group (55 cases) and an anticoagulant therapy group (210 cases) according to treatment measure. All patients were followed up for 3 months to 2 years through regular review. The one-year PE and deep vein thrombosis (DVT) recurrence rates, one-year mortality and two-year mortality were compared between two groups. Results The PE and DVT recurrence rates were 9.1% and 21.8% in the IVCF treatment group, and were 18.6% and 11.0% in the anticoagulant therapy group, respectively. The PE recurrence rate was lower and the DVT recurrence rate was higher in the IVCF treatment group compared with the anticoagulant therapy group, the differences were statistically significant (P<0.05). The one-year mortality (29.1% vs. 12.9%) and two-year mortality (34.5% vs. 14.8%) were significantly higher in the IVCF treatment group than those in the anticoagulant therapy group (P<0.05). Conclusions IVCF without anticoagulation can reduce incidence of pulmonary embolism caused by the lower extremity DVT, but will increase DVT recurrence rate. It may be an alternative option for prevention of PE in patients with contraindications to anticoagulant therapy or recurrent PE patients after regular anticoagulant therapy.

Citation： WANG Baofeng, GUAN Min, ZHANG Chunfeng. Effectiveness of inferior vena cava filters without anticoagulation therapy for prophylaxis of recurrent pulmonary embolism. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(4): 379-382. doi: 10.7507/1671-6205.201612011 Copy

1.	Franco P, Losub DI. New anticoagulants in the management of venous thromboembolism in women. Thromb Res, 2015, 135(Suppl 1): S5-S7.
2.	Arcelus JI, Domènech P, Fernández-Capitan Mdel C, et al. Rivaroxaban in the treatment of venous thromboembolism and the prevention of recurrences: a practical approach. Clin Appl Thromb Hemost, 2015, 21(4): 297-308.
3.	孫曉磊, 王偉明, 張雷, 等. 下腔靜脈濾器聯合順行置管溶栓在下肢急性深靜脈血栓形成中的療效分析. 四川醫學, 2016, 37(9): 1030-1033.
4.	Davies MC, Hart JP, El Saved HF. Efficacy of prophylactic inferior vena caval filters in prevention of pulmonary embolism in the absence of deep venous thrombosis. J Vasc Surg Venous Lymphat Disord, 2016, 4(1): 127-130.
5.	Liew A, Douketis J. Catheter-directed thrombolysis for extensive iliofemoral deep vein thrombosis: review of literature and ongoing trials. Expert Rev Cardiovasc Ther, 2016, 14(2): 189-200.
6.	李曉陽, 王國亮, 王李華. 導管接觸性溶栓治療急性下肢深靜脈血栓形成的研究進展. 浙江醫學, 2016, 38(19): 1625-1628.
7.	Vedantham S, Sista A K, Klein S J, et al. Quality improvement guidelines for the treatment of lower-extremity deep vein thrombosis with use of endovascular thrombus removal. J Vasc Interv Radiol, 2014, 25(9): 1317-1325.
8.	Kearon C, Akl EA, Ornelas J, et al. Antithrombotic Therapy for VTE disease: CHEST Guideline and Expert Panel Report. Chest, 2016, 149(2): 315-352.
9.	Patra S, Srinivas BC, Nagesh CM, et al. Endovascular management of proximal lower limb deep venous thrombosis- A prospective study with six-month follow-up. Phlebology, 2015, 30(7): 441-448.
10.	Duan PF, Ni CF. Randomized study of different approaches for catheter-directed thrombolysis for lower-extremity acute deep venous thrombosis. J Formos Med Assoc, 2015, 115(8): 652-657.
11.	賈偉, 劉建龍, 田軒, 等. 下腔靜脈濾器置入在預防下肢深靜脈血栓形成繼發性肺栓塞中的臨床意義. 實用醫學雜志, 2016, 32(3): 458-460.
12.	張學民, 張韜, 張小明, 等. 下肢深靜脈血栓形成導管接觸溶栓與外周靜脈系統溶栓早期療效的對比研究. 中國微創外科雜志, 2016, 16(3): 228-232.
13.	Du XL, Kong LS, Meng QY, et al. Safety and efficacy of low dosage of urokinase for catheter-directed thrombolysis of deep venous thrombosis. Chin Med J (Engl), 2015, 128(13): 1787-1792.
14.	Caplin DM, Nikolic B, Kalva SP, et al. Quality improvement guidelines for the performance of inferior vena cava filter placement for the prevention of pulmonary embolism. J Vasc Interv Radiol, 2011;22(11): 1499-1506.
15.	Bacchus F, Schulman S. Clinical experience with the new oral anticoagulants for treatment of venous thromboembolism. Arterioscler Thromb Vasc Biol, 2015, 35(3):513-519.

1. Franco P, Losub DI. New anticoagulants in the management of venous thromboembolism in women. Thromb Res, 2015, 135(Suppl 1): S5-S7.
2. Arcelus JI, Domènech P, Fernández-Capitan Mdel C, et al. Rivaroxaban in the treatment of venous thromboembolism and the prevention of recurrences: a practical approach. Clin Appl Thromb Hemost, 2015, 21(4): 297-308.
3. 孫曉磊, 王偉明, 張雷, 等. 下腔靜脈濾器聯合順行置管溶栓在下肢急性深靜脈血栓形成中的療效分析. 四川醫學, 2016, 37(9): 1030-1033.
4. Davies MC, Hart JP, El Saved HF. Efficacy of prophylactic inferior vena caval filters in prevention of pulmonary embolism in the absence of deep venous thrombosis. J Vasc Surg Venous Lymphat Disord, 2016, 4(1): 127-130.
5. Liew A, Douketis J. Catheter-directed thrombolysis for extensive iliofemoral deep vein thrombosis: review of literature and ongoing trials. Expert Rev Cardiovasc Ther, 2016, 14(2): 189-200.
6. 李曉陽, 王國亮, 王李華. 導管接觸性溶栓治療急性下肢深靜脈血栓形成的研究進展. 浙江醫學, 2016, 38(19): 1625-1628.
7. Vedantham S, Sista A K, Klein S J, et al. Quality improvement guidelines for the treatment of lower-extremity deep vein thrombosis with use of endovascular thrombus removal. J Vasc Interv Radiol, 2014, 25(9): 1317-1325.
8. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic Therapy for VTE disease: CHEST Guideline and Expert Panel Report. Chest, 2016, 149(2): 315-352.
9. Patra S, Srinivas BC, Nagesh CM, et al. Endovascular management of proximal lower limb deep venous thrombosis- A prospective study with six-month follow-up. Phlebology, 2015, 30(7): 441-448.
10. Duan PF, Ni CF. Randomized study of different approaches for catheter-directed thrombolysis for lower-extremity acute deep venous thrombosis. J Formos Med Assoc, 2015, 115(8): 652-657.
11. 賈偉, 劉建龍, 田軒, 等. 下腔靜脈濾器置入在預防下肢深靜脈血栓形成繼發性肺栓塞中的臨床意義. 實用醫學雜志, 2016, 32(3): 458-460.
12. 張學民, 張韜, 張小明, 等. 下肢深靜脈血栓形成導管接觸溶栓與外周靜脈系統溶栓早期療效的對比研究. 中國微創外科雜志, 2016, 16(3): 228-232.
13. Du XL, Kong LS, Meng QY, et al. Safety and efficacy of low dosage of urokinase for catheter-directed thrombolysis of deep venous thrombosis. Chin Med J (Engl), 2015, 128(13): 1787-1792.
14. Caplin DM, Nikolic B, Kalva SP, et al. Quality improvement guidelines for the performance of inferior vena cava filter placement for the prevention of pulmonary embolism. J Vasc Interv Radiol, 2011;22(11): 1499-1506.
15. Bacchus F, Schulman S. Clinical experience with the new oral anticoagulants for treatment of venous thromboembolism. Arterioscler Thromb Vasc Biol, 2015, 35(3):513-519.

Chinese Journal of Respiratory and Critical Care Medicine

Effectiveness of inferior vena cava filters without anticoagulation therapy for prophylaxis of recurrent pulmonary embolism

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