D Baschera1, J Sebunya, C Walter, R Zellweger. 1. Department of Orthopaedic and Trauma Surgery, Royal Perth Hospital, North Block, Level 5, Wellington Street, 6000, Perth, Australien. dbaschera@bluewin.ch
Abstract
BACKGROUND: The introduction of removable inferior vena cava filters (IVCF) has created new options for the prevention of pulmonary embolisms in surgical trauma patients. We have observed increasing use in trauma patients. PATIENTS AND METHODS: A retrospective analysis was carried out of 49 trauma patients out of 85 who received IVCFs at our level 1 trauma centre in 2008. RESULTS: The indications for IVCF placement were multiple trauma in 33 patients, severe head injury in 13 and spinal injury in 3 patients. Of the patients 34 underwent successful removal, 11 (22%) patients had had no retrieval attempt by December 2009 and attempts at removal were unsuccessful in 3 patients. The mean age of the patients was 33.3 years. CONCLUSION: In 2008 the vast majority of IVCFs were inserted for prophylaxis in trauma patients. To increase the number of retrieved IVCFs, responsibility for the removal should be clarified in every hospital. The indications, advantages, safety and also the design of IVCFs are still under debate. A randomized controlled trial is needed to determine the appropriate use and indications for this potentially useful device in trauma patients.
BACKGROUND: The introduction of removable inferior vena cava filters (IVCF) has created new options for the prevention of pulmonary embolisms in surgical traumapatients. We have observed increasing use in traumapatients. PATIENTS AND METHODS: A retrospective analysis was carried out of 49 traumapatients out of 85 who received IVCFs at our level 1 trauma centre in 2008. RESULTS: The indications for IVCF placement were multiple trauma in 33 patients, severe head injury in 13 and spinal injury in 3 patients. Of the patients 34 underwent successful removal, 11 (22%) patients had had no retrieval attempt by December 2009 and attempts at removal were unsuccessful in 3 patients. The mean age of the patients was 33.3 years. CONCLUSION: In 2008 the vast majority of IVCFs were inserted for prophylaxis in traumapatients. To increase the number of retrieved IVCFs, responsibility for the removal should be clarified in every hospital. The indications, advantages, safety and also the design of IVCFs are still under debate. A randomized controlled trial is needed to determine the appropriate use and indications for this potentially useful device in traumapatients.
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