INTRODUCTION: Pulmonary embolus (PE) is a potentially devastating and fatal postoperative complication in morbidly obese patients. This study was undertaken to review the safety and efficacy of retrievable prophylactic inferior vena cava (IVC) filters in high-risk morbidly obese patients undergoing gastric bypass. METHODS: Patients who underwent gastric bypass surgery and preoperative insertion of retrievable IVC filters had their records reviewed. Indications for IVC filter insertion were: history of deep venous thrombosis (DVT) or PE, long-standing sleep apnea, venous stasis disease, and/or weight > 400 pounds. RESULTS: 24 patients underwent IVC filter placement before gastric bypass surgery. There were 10 women and 14 men with an average age of 50 +/- 6.3 years (range 39 to 59) and average body mass index (BMI) of 57 +/- 7.5 kg/m(2) (range 49 to 74). BMI greater then 50 kg/m(2) was present in 21 of 24 patients (88%). All patients had successful IVC filter placement. IVC filter retrieval postoperatively was performed in 20 of 24 patients (83%) with three left for clinical reasons and one (4%) left due to technical inability to retrieve. There was one complication directly attributable to IVC filter retrieval. There were no deaths. Five patients (21%) developed DVT or PE postoperatively. Follow-up was 16 +/- 7.6 months (range 8 to 33). CONCLUSIONS: Prophylactic IVC filter placement and retrieval can be safely undertaken in high-risk gastric bypass patients. We recommend preoperative IVC filter placement in selected patients.
INTRODUCTION:Pulmonary embolus (PE) is a potentially devastating and fatal postoperative complication in morbidly obesepatients. This study was undertaken to review the safety and efficacy of retrievable prophylactic inferior vena cava (IVC) filters in high-risk morbidly obesepatients undergoing gastric bypass. METHODS:Patients who underwent gastric bypass surgery and preoperative insertion of retrievable IVC filters had their records reviewed. Indications for IVC filter insertion were: history of deep venous thrombosis (DVT) or PE, long-standing sleep apnea, venous stasis disease, and/or weight > 400 pounds. RESULTS: 24 patients underwent IVC filter placement before gastric bypass surgery. There were 10 women and 14 men with an average age of 50 +/- 6.3 years (range 39 to 59) and average body mass index (BMI) of 57 +/- 7.5 kg/m(2) (range 49 to 74). BMI greater then 50 kg/m(2) was present in 21 of 24 patients (88%). All patients had successful IVC filter placement. IVC filter retrieval postoperatively was performed in 20 of 24 patients (83%) with three left for clinical reasons and one (4%) left due to technical inability to retrieve. There was one complication directly attributable to IVC filter retrieval. There were no deaths. Five patients (21%) developed DVT or PE postoperatively. Follow-up was 16 +/- 7.6 months (range 8 to 33). CONCLUSIONS: Prophylactic IVC filter placement and retrieval can be safely undertaken in high-risk gastric bypass patients. We recommend preoperative IVC filter placement in selected patients.
Authors: H Decousus; A Leizorovicz; F Parent; Y Page; B Tardy; P Girard; S Laporte; R Faivre; B Charbonnier; F G Barral; Y Huet; G Simonneau Journal: N Engl J Med Date: 1998-02-12 Impact factor: 91.245
Authors: Charlotte A Schoenborn; Patricia F Adams; Patricia M Barnes; Jackline L Vickerie; Jeannine S Schiller Journal: Vital Health Stat 10 Date: 2004-02
Authors: Khashayar Vaziri; J Devin Watson; Amy P Harper; Juliet Lee; Fredrick J Brody; Shawn Sarin; Elizabeth A Ignacio; Albert Chun; Anthony C Venbrux; Paul P Lin Journal: Obes Surg Date: 2011-10 Impact factor: 4.129
Authors: D Wayne Overby; Geoffrey P Kohn; Mitchell A Cahan; Robert G Dixon; Joseph M Stavas; Stephan Moll; Charles T Burke; Karen J Colton; Timothy M Farrell Journal: Obes Surg Date: 2009-01-06 Impact factor: 4.129