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Semin intervent Radiol 2001; 18(2): 119-130
DOI: 10.1055/s-2001-15173
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Vena Cava Filters

Jan Namyslowski
  • Section of Vascular and Interventional Radiology, Indiana University School of Medicine, University Hospital, Indianapolis, Indiana
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Publication History

Publication Date:
31 December 2001 (online)

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ABSTRACT

Vena cava filters play an important role in the management of thromboembolic disease. With careful adherence to preinsertion evaluation, placement technique, and postplacement management, these devices may offer substantial benefits to the patients at risk. Caval filtration devices are reviewed in this article with particular emphasis on those available on the U.S. market. Clinical assessment, technical characteristics, filter performance, and complications are discussed. Vena cava imaging issues pertinent to filter insertion are reviewed. A brief overview of temporary and retrievable filters is included.

KEYWORD

Vena cava filters - thromboembolic disease - venography

REFERENCES

  • 1 Mobin-Uddin K, Smith P E, Martinez L O, Lombardo C R, Jude J R. A vena cava filter for the prevention of pulmonary embolus.  Surgical Forum . 1967;  18 209-211
    PubMedGoogle Scholar
  • 2 Mobin-Uddin K, McLean R, Bolloki H, Jude J R. Caval interruption for prevention of pulmonary embolism: long term results of a new method.  Arch Surg . 1969;  99 711-715
    PubMedGoogle Scholar
  • 3 Cimochowski G E, Evans R H, Zarins C K, Lu C-T, DeMeester T R. Greenfield filter versus Mobin-Uddin umbrella.  J Thorac Cardiovasc Surg . 1980;  79 358-365
    PubMedGoogle Scholar
  • 4 Greenfield L J, McCurdy J R, Brown P P, Elkins R C. A new intracaval filter permitting continued flow and resolution of emboli.  Surgery . 1973;  73 599-606
    PubMedGoogle Scholar
  • 5 Golueke P J, Garrett W V, Thompson J E, Smith B L, Talkington C M. Interruption of the vena cava by means of the Greenfield filter: expanding the indications.  Surgery . 1988;  103 111-117
    PubMedGoogle Scholar
  • 6 Rohrer M J, Scheidler M G, Wheeler H B, Cutler B S. Extended indications for placement of an inferior vena cava filter.  J Vasc Surg . 1989;  10 44-50
    CrossrefPubMedGoogle Scholar
  • 7 Norris C S, Greenfield L J, Herrmann J B. Free-floating iliofemoral thrombus.  Arch Surg . 1985;  120 806-808
    PubMedGoogle Scholar
  • 8 Baldridge E D, Martin M A, Welling R E. Clinical significance of free-floating venous thrombi.  J Vasc Surg . 1990;  11 62-69
    PubMedGoogle Scholar
  • 9 Menzoian J O, Sequeira J C, Doyle J E. Therapeutic and clinical course of deep vein thrombosis.  Am J Surg . 1983;  146 581-585
    CrossrefPubMedGoogle Scholar
  • 10 Pacouret G, Alison D, Pottier J, Bertrand P, Charbonnier B. Free-floating thrombus and embolic risk in patients with angiographically confirmed proximal deep venous thrombosis.  Arch Intern Med . 1997;  157 305-308
    PubMedGoogle Scholar
  • 11 Rogers, F B, Shackford S R, Ricci M A, Wilson J T, Parsons S. Routine prophylactic vena cava filter insertion in severely injured trauma patients decreases the incidence of pulmonary embolism.  J Am Coll Surg . 1995;  180 641-647
    PubMedGoogle Scholar
  • 12 O'Malley K F, Ross S E. Pulmonary embolism in major trauma patients.  J Trauma . 1990;  30 748-750
    PubMedGoogle Scholar
  • 13 Winchell R J, Hoyt D B, Walsh J C, Simons R K, Eastman A B. Risk factors associated with pulmonary embolism despite routine prophylaxis: implications for improved protection.  J Trauma . 1994;  37 600-606
    CrossrefPubMedGoogle Scholar
  • 14 Rogers F B, Strindberg G, Shackford S R. Five-year follow-up of prophylactic vena cava filters in high-risk trauma patients.  Arch Surg . 1998;  133 406-411
    CrossrefPubMedGoogle Scholar
  • 15 Khansarinia S, Dennis J W, Veldenz H C, Butcher J L, Hartland L. Prophylactic Greenfield filter placement in selected high-risk trauma patients.  J Vasc Surg . 1995;  22 231-236
    CrossrefPubMedGoogle Scholar
  • 16 Leach T A, Pastena J A, Swan K G. Surgical prophylaxis for pulmonary embolism.  Am Surg . 1994;  60 292-295
    PubMedGoogle Scholar
  • 17 Geerts W H, Code K I, Jay R M, Chen E, Szalai J P. A prospective study of venous thromboembolism after major trauma.  N Engl J Med . 1994;  331 1601-1606
    CrossrefPubMedGoogle Scholar
  • 18 Rodriguez J L, Lopez J M, Proctor M C. Early placement of prophylactic vena caval filters in injured patients at high risk for pulmonary embolism.  J Trauma . 1996;  40 797-804
    CrossrefPubMedGoogle Scholar
  • 19 Patton Jr H J, Fabian T C, Croce M A. Prophylactic Greenfield filters: acute complications and long-term follow-up.  J Trauma . 1996;  41 231-237
    PubMedGoogle Scholar
  • 20 Langan III M E, Miller R S, Casey III J W. Prophylactic inferior vena cava filters in trauma patients at high risk: follow-up examination and risk/benefit assessment.  J Vasc Surg . 1999;  30 484-490
    CrossrefPubMedGoogle Scholar
  • 21 McMurtry A L, Owings J T, Anderson J T, Battistella F D, Gosselin R. Increased use of prophylactic vena cava filters in trauma patients failed to decrease overall incidence of pulmonary embolism.  J Am Coll Surg . 1999;  189 314-320
    CrossrefPubMedGoogle Scholar
  • 22 AbuRahma A F, Robinson P A, Boland J P. Therapeutic and prophylactic vena caval interruption for pulmonary embolism: caval and venous insertion site patency.  Ann Vasc Surg . 1993;  7 561-568
    PubMedGoogle Scholar
  • 23 Greenfield L J, Rutherford R B. Recommended reporting standards for vena caval filter placement and patient follow-up.  J Vasc Intervent Radiol . 1999;  10 1013-1019
    PubMedGoogle Scholar
  • 24 Greenfield L J, Michna B A. Twelve-year clinical experience with the Greenfield vena caval filter.  Surgery . 1988;  104 706-712
    PubMedGoogle Scholar
  • 25 Greenfield L J, Peyton R, Crute S, Barnes R. Greenfield vena caval filter experience. Late results in 156 patients.  Arch Surg . 1981;  116 1451-1456
    CrossrefPubMedGoogle Scholar
  • 26 Greenfield L J, Zocco J, Wilk J, Schroeder T M, Elkins, R C. Clinical experience with the Kim-Ray Greenfield vena caval filter.  Ann Surg . 1977;  185 692-696
    PubMedGoogle Scholar
  • 27 Kolachalam R B, Julian T B. Clinical presentation of thrombosed Greenfield filters.  Vasc Surg . 1990;  666-670
    PubMedGoogle Scholar
  • 28 Lang W, Schweiger H, Hofmann-Preiss K. Results of long-term venacavography study after placement of a Greenfield vena caval filter.  J Cardiovasc Surg . 1992;  33 573-578
    PubMedGoogle Scholar
  • 29 Dorfman G S, Cronan J J, Paolella L P. Iatrogenic changes at the venotomy site after percutaneous placement of the Greenfield filter.  Radiology . 1989;  173 159-162
    PubMedGoogle Scholar
  • 30 Kantor A, Glanz S, Gordon D H, Sclafani S J. Percutaneous insertion of the Kimray-Greenfield filter.  Am J Roentgenol . 1987;  149 1065-1066
    PubMedGoogle Scholar
  • 31 Wojtowycz M M, Stoehr T, Crummy A B, McDermott J C, Sproat I A. The Bird's nest inferior vena caval filter: review of a single-center experience.  J Vasc Intervent Radiol . 1997;  8 171-179
    PubMedGoogle Scholar
  • 32 Thomas J H, Cornell K M, Siegel E L, Sparks C, Rosenthal S J. Vena caval occlusion after Bird's nest filter placement.  Am J Surg . 1998;  176 598-600
    CrossrefPubMedGoogle Scholar
  • 33 Nicholson A A, Ettles D F, Paddon A J, Dyet J F. Long-term follow-up of the Bird's nest IVC filter.  Clin Radiol . 1999;  54 759-764
    CrossrefPubMedGoogle Scholar
  • 34 Mohan C R, Hoballah J J, Sharp W J. Comparative efficacy and complications of vena caval filters.  J Vasc Surg . 1995;  21 235-246
    PubMedGoogle Scholar
  • 35 Vesely T M. Technical problems and complications associated with inferior vena cava filters.  Semin Intervent Radiol . 1994;  11 121-133
    PubMedGoogle Scholar
  • 36 Roehm Jr O J, Thomas J W. The twist technique: a method to minimize wire prolapse during Bird's nest filter placement.  J Vasc Intervent Radiol . 1995;  6 455-459
    PubMedGoogle Scholar
  • 37 Engmann E, Asch M R. Clinical experience with the antecubital Simon nitinol IVC filter.  J Vasc Intervent Radiol . 1998;  9 774-778
    PubMedGoogle Scholar
  • 38 Simon M, Athanasoulis C A, Kim D. Simon nitinol inferior vena cava filter: Initial clinical experience.  Radiology . 1989;  172 99-103
    CrossrefPubMedGoogle Scholar
  • 39 Dorfman G S. Percutaneous inferior vena caval filters.  Radiology . 1990;  174 987-992
    PubMedGoogle Scholar
  • 40 Athanasoulis C A, Kaufman J A, Halpern E F. Inferior vena caval filters: review of a 26-year single-center clinical experience.  Radiology . 2000;  216 54-66
    CrossrefPubMedGoogle Scholar
  • 41 Poletti P A, Becker C D, Prina L. Long-term results of the Simon nitinol inferior vena cava filter.  Eur Radiol . 1998;  8 289-294
    CrossrefPubMedGoogle Scholar
  • 42 Thomas D L, McFarland D R, Price M B, Thomas D L, Ferris E J. Fractures of Simon-nitinol inferior vena cava filters: follow-up experience.  J Vasc Intervent Radiol . 1997;  8(Suppl 1) 197(Abstr)
    PubMedGoogle Scholar
  • 43 Bjarnason H, Yedlicka Jr W J, Hunter D W, Castaneda-Zuniga W R, Amplatz K. In vitro metal fatigue testing of inferior vena cava filters.  Invest Radiol . 1994;  29 817-821
    PubMedGoogle Scholar
  • 44 Greenfield L J, Cho K J, Tauscher J R. Evolution of hook design for fixation of the titanium Greenfield filter.  J Vasc Surg . 1990;  12 345-353
    PubMedGoogle Scholar
  • 45 Greenfield L J, Proctor M C, Cho K J. Extended evaluation of the titanium Greenfield vena caval filter.  J Vasc Surg . 1994;  20 458-465
    CrossrefPubMedGoogle Scholar
  • 46 Crochet D P, Stora O, Ferry D. Vena Tech-LGM Filter: long-term results of a prospective study.  Radiology . 1993;  188 857-860
    PubMedGoogle Scholar
  • 47 Crochet D P, Brunel P, Trogrlic S. Long-term follow-up of Vena Tech-LGM filter: predictors and frequency of caval occlusion.  J Vasc Intervent Radiol . 1999;  10 137-142
    CrossrefPubMedGoogle Scholar
  • 48 Cho K J, Greenfield L J, Proctor M C. Evaluation of a new percutaneous stainless steel Greenfield filter.  J Vasc Intervent Radiol . 1997;  8 181-187
    PubMedGoogle Scholar
  • 49 Johnson S P, Raiken D P, Grebe P J, Diffin D C, Leyendecker J R. Single institution prospective evaluation of the over-the-wire Greenfield vena caval filter.  J Vasc Intervent Radiol . 1998;  9 766-773
    PubMedGoogle Scholar
  • 50 Kadir S. Atlas of Normal and Variant Angiographic Anatomy.  Philadelphia: W B Saunders 1991: 387-428
    Google Scholar
  • 51 Hicks M E, Malden E S, Vesely T M, Picus D, Darcy M D. Prospective anatomic study of the inferior vena cava and renal veins: comparison of selective renal venography with cavography and relevance in filter placement.  J Vasc Intervent Radiol . 1995;  6 721-729
    PubMedGoogle Scholar
  • 52 Kaufman J A, Waltman A C, Rivitz S M, Geller S C. Anatomical observations on the renal veins and inferior vena cava at magnetic resonance angiography.  Cardiovasc Intervent Radiol . 1995;  18 153-157
    PubMedGoogle Scholar
  • 53 Trigaux J-P, Vandroogenbroek S, De Wispelaere J-F, Lacrosse M, Jamart J. Congenital anomalies of the inferior vena cava and left renal vein: evaluation with spiral CT.  J Vasc Intervent Radiol . 1998;  9 339-345
    PubMedGoogle Scholar
  • 54 Boyd-Kranis R, Sullivan K L, Eschelman D J, Bonn J, Gardiner G A. Accuracy and safety of carbon dioxide inferior vena cavography.  J Vasc Intervent Radiol . 1999;  10 1183-1189
    PubMedGoogle Scholar
  • 55 Kaufman J A, Geller S C, Bazari H, Waltman A C. Gadolinium-based contrast agents as an alternative at vena cavography in patients with renal insufficiency-early experience.  Radiology . 1999;  212 280-284
    PubMedGoogle Scholar
  • 56 Sing R F, Cicci C K, Smith C H, Messick W J. Bedside insertion of inferior vena cava filters in the intensive care unit.  J Trauma . 1999;  47 1104-1107
    PubMedGoogle Scholar
  • 57 Sato D T, Robinson K D, Gregory R T. Duplex directed caval filter insertion in multi-trauma and critically ill patients.  Ann Vasc Surg . 1999;  13 365-371
    CrossrefPubMedGoogle Scholar
  • 58 Tola J C, Holtzman R, Lottenberg L. Bedside placement of inferior vena cava filters in the intensive care unit.  Am Surg . 1999;  65 833-838
    PubMedGoogle Scholar
  • 59 Kim D, Edelman R P, Margolin C J. The Simon nitinol filter: evaluation by MR and ultrasound.  Angiology . 1992;  43 541-548
    CrossrefPubMedGoogle Scholar
  • 60 Pasto M E, Kurtz A B, Jarrell B E. The Kimray-Greenfield filter: evaluation by duplex real-time/pulsed Doppler ultrasound.  Radiology . 1983;  148 223-226
    PubMedGoogle Scholar
  • 61 Markel A, Goldman M L, Coldwell D M, Manzo R A, Strandness D E. Follow-up of percutaneously placed inferior vena cava filters by duplex scanning.  J Vasc Technol . 1992;  16 74-78
    PubMedGoogle Scholar
  • 62 Bonn J, Liu J-B, Eschelman D J. Intravascular ultrasound as an alternative to filter placement.  J Vasc Intervent Radiol . 1999;  10 843-849
    PubMedGoogle Scholar
  • 63 McCowan T C, Ferris E J, Carver D K. Inferior vena caval filter thrombi: evaluation with intravascular US.  Radiology . 1990;  177 783-788
    PubMedGoogle Scholar
  • 64 Marx M V, Tauscher J R, Williams D M, Greenfield L J. Evaluation of the inferior vena cava with intravascular US after Greenfield filter placement.  J Vasc Intervent Radiol . 1991;  2 261-268
    PubMedGoogle Scholar
  • 65 Kaufman J A, Geller S C, Rivitz S M, Waltman A C. Operator errors during percutaneous placement of vena cava filters.  Am J Roentgenol . 1995;  165 1281-1287
    PubMedGoogle Scholar
  • 66 Becker D M, Philbrick J T, Selby J B. Inferior vena cava filters: indications, safety, effectiveness.  Arch Intern Med . 1992;  152 1985-1994
    CrossrefPubMedGoogle Scholar
  • 67 Kaufman J A, Thomas J W, Geller S C, Rivitz S M, Waltman A C. Guidewire entrapment by inferior vena caval filters: in vitro evaluation.  Radiology . 1996;  198 71-76
    PubMedGoogle Scholar
  • 68 Denny Jr F D, Dorfman G S, Cronan J J. Greenfield filter: percutaneous placement in 50 patients.  Am J Roentgenol . 1988;  150 427-429
    PubMedGoogle Scholar
  • 69 Molgaard C P, Yucel E K, Geller S C, Knox T A, Waltman A C. Access-site thrombosis after placement of inferior vena cava filters with 12-14-F delivery sheaths.  Radiology . 1992;  185 257-261
    PubMedGoogle Scholar
  • 70 Thompson B H, Cragg A H, Smith T P. Thrombus-trapping efficiency of the Greenfield filter in vivo.  Radiology . 1989;  172 979-981
    PubMedGoogle Scholar
  • 71 Katsamouris A A, Waltman A C, Delichatsios M A, Athanasoulis C A. Inferior vena cava filters: in vitro comparison of clot trapping and flow dynamics.  Radiology . 1988;  166 361-366
    PubMedGoogle Scholar
  • 72 Simon M. Vena cava filters: prevalent misconceptions.  J Vasc Intervent Radiol . 1999;  10 1021-1024
    PubMedGoogle Scholar
  • 73 Taheri S A, Kulaylat M N, Johnson E, Hoover E. A complication of the Greenfield filter: fracture and distal migration of two struts-a case report.  J Vasc Surg . 1992;  16 96-99
    PubMedGoogle Scholar
  • 74 Kupferschmid J P, Dickson C S, Townsend R N, Diamond D L. Small-bowel obstruction from an extruded Greenfield filter strut: an unusual late complication.  J Vasc Surg . 1992;  16 113-115
    PubMedGoogle Scholar
  • 75 Hirsh J, Hoak J. Management of deep vein thrombosis and pulmonary embolism.  Circulation . 1996;  93 2212-2245
    CrossrefPubMedGoogle Scholar
  • 76 Tai N RM, Atwal A S, Hamilton G. Modern management of pulmonary embolism.  Br J Surg . 1999;  86 853-868
    CrossrefPubMedGoogle Scholar
  • 77 Goldhaber S Z. Optimizing anticoagulant therapy in the management of pulmonary embolism.  Semin Thromb Hemost . 1999;  25(Suppl 3) 129-133
    PubMedGoogle Scholar
  • 78 David W, Gross W S, Colaiuta E, Gonda R, Osher D, Lanuti S. Pulmonary embolus after vena cava filter placement.  Am Surg . 1999;  65 341-346
    PubMedGoogle Scholar
  • 79 Ortega M, Gahtan V, Roberts A, Matsumoto T, Kerstein M. Efficacy of anticoagulation post-inferior vena caval filter placement.  Am Surg . 1998;  64 419-423
    PubMedGoogle Scholar
  • 80 Cope C, Baum R A, Duszak Jr A R. Temporary use of a bird's nest filter during iliocaval thrombolysis.  Radiology . 1996;  198 765-767
    PubMedGoogle Scholar
  • 81 Goto Y, Niwa A, Korenaga T. The efficacy of temporary inferior vena caval filter in the prevention or treatment of pulmonary thrombolytic embolism (PTE).  Cardiovasc Intervent Radiol . 1997;  20(Suppl 1) S127 Abstract
    PubMedGoogle Scholar
  • 82 Miller W J, Pieters P C. Temporary filter/infusion catheter system: indications, uses, and technical notes.  J Vasc Intervent Radiol . 1996;  7(Suppl 1) 290 Abstract
    PubMedGoogle Scholar
  • 83 Vorwerk D, Schmitz-Rode T, Schürmann K, Tacke J, Guenther R W. Use of a temporary caval filter to assist percutaneous iliocaval thrombectomy: experimental results.  J Vasc Intervent Radiol . 1995;  6 737-740
    PubMedGoogle Scholar
  • 84 Bovyn G, Gory P, Reynaud P, Ricco J-B. The Tempofilter: a multicenter study of a new temporary caval filter implantable for up to six weeks.  Ann Vasc Surg . 1997;  11 520-528
    CrossrefPubMedGoogle Scholar
  • 85 Kelly I MG, Boyd C S. Buckling of the tethering catheter causes migration of a temporary caval filter to the right atrium.  Clin Radiol . 1999;  54 398-401
    CrossrefPubMedGoogle Scholar
  • 86 Rossi, P, Arata F M, Bonaiuti P, Pedicini V. Fatal outcome in atrial migration of the Tempofilter.  Cardiovasc Intervent Radiol . 1999;  22 227-231
    CrossrefPubMedGoogle Scholar
  • 87 Neuerburg J M, Günther R W, Vorwerk D. Results of a multicenter study of the retrievable Tulip Vena Cava Filter: early clinical experience.  Cardiovasc Intervent Radiol . 1997;  20 10-16
    CrossrefPubMedGoogle Scholar
  • 88 Millward S F. Temporary and retrievable inferior vena cava filters: current status.  J Vasc Intervent Radiol . 1998;  9 381-387
    PubMedGoogle Scholar
  • 89 Greenfield L J, Proctor M C. Suprarenal filter placement.  J Vasc Surg . 1998;  28 432-438
    PubMedGoogle Scholar
  • 90 Matchett W J, Jones M P, McFarland D R, Ferris E J. Suprarenal vena caval filter placement: follow-up of four filter types in 22 patients.  J Vasc Intervent Radiol . 1998;  9 588-593
    PubMedGoogle Scholar
  • 91 Peyton J WR, Stewart J R, Greenfield L J, Crute S L. Hemodynamics and renal function following experimental suprarenal vena caval occlusion.  Surg Gynecol Obstet . 1982;  155 37-42
    PubMedGoogle Scholar
  • 92 Horattas M C, Wright D J, Fenton A H. Changing concepts of deep venous thrombosis of the upper extremity: report of a series and review of the literature.  Surgery . 1988;  104 561-567
    PubMedGoogle Scholar
  • 93 Monreal M, Lafoz E, Ruiz J, Valls R, Alastrue A. Upper-extremity deep venous thrombosis and pulmonary embolism. A prospective study.  Chest . 1991;  99 280-283
    CrossrefPubMedGoogle Scholar
  • 94 Spence L D, Gironta M G, Malde H M, Mickolick C T, Geisinger M A, Dolmatch B L. Acute upper extremity deep venous thrombosis: safety and effectiveness of superior vena caval filters.  Radiology . 1999;  210 53-58
    PubMedGoogle Scholar
  • 95 Ascer E, Gennaro M, Lorensen E, Pollina R M. Superior vena caval Greenfield filters: indications, techniques, and results.  J Vasc Surg . 1996;  23 498-503
    PubMedGoogle Scholar