J.Jpn. Surg. Soc.. 105(6): 369-373, 2004

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Feature topic

TEMPORARY VENA CAVA FILTERS FOR PREVENTION OF PULMONARY EMBOLISM

Pulmonary embolism (PE) is a serious complication in deep venous thrombosis (DVT), and the prevention of PE is a major target of treatment. Vena cava filters (VCF) can be inserted,and the temporary type and retrievable type of VCF have appeared in recent years in addition to permanent models. These have introduced new criteria for VCF insertion and changes in the algorithm for the treatment of PE. Among cases traditionally calling for permanent VCF, those requiring prevention of PE, especially in the early stage, are suitable for temporary VCF insertion. These include floating thrombi in the acute DVT phase, the perioperative period of thrombectomy or endovascular treatment for DVT, surgery for an abdominal masscompressing the vena cava or iliac veins, and secondary prophylaxis in the early stage of PE. High-risk patients such as parturient cases with DVT and those with multiple traumatic injuries should also be considered. However, there is little evidence concernlng temporary VCF, and further investigations are necessary on insertion methods and indications.

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