are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery?

PABLO A. I. SLULLITEL; FERNANDO DÍAZ DILERNIA; JOAQUÍN STAGNARO; MARIANO REVAH; LILIANA P. ROJAS; MARIA LOURDES POSADAS MARTINEZ; MARTÍN A. BUTTARO; GASTÓN A. SLULLITEL

Rev Fac Cien Med Univ Nac Cordoba

Rev Fac Cien Med Univ Nac Cordoba

Año: 2018

0014-6722

Background: Thromboprophylaxis may be insufficient to prevent thromboembolic events in high risk patientsafter orthopaedic procedures. In this scenario, a retrievable vena cava filter (VCF) could be considered asan alternative, although it's use remains controversial. Aim: To estimate mortality, mechanical andhematological complications associated with the use of retrievable VCFs in orthopaedic surgery Methods:Retrospective cohort of patients with history of thromboembolic (TED) disease who underwent orthopaedicsurgery and a retrievable VCF was placed, between 2006-2014 at Hospital Italiano de Buenos Aires.Permanent filters were excluded. The main outcomes were filter?s mechanical complications, hematologiccomplications (TED recurrence, post-thrombotic syndrome and major bleeding) and death. To estimateassociation with risk factors, we subclassified surgeries into 5 groups: 1, arthroplasty/non-arthroplasty; 2,primary/revision; 3, elective/urgent; 4, oncologic/non-oncologic; 5, preoperative/postoperative filter. Results:Sixty eight patients were included, of those 31 presented a complication. Mechanical complications were16% and required a filter revision. Sixty-four percent of the revised VCFs developed a mechanical failure andcould not be retrieved. Overall prevalence of TED recurrence, post-thrombotic syndrome and hemorrhagewas 33%, 15% and 4.5%, respectively. Spinal surgeries were a risk factor for developing TED recurrences.The mortality rate was 28% and death related with TED recurrence 4%. Conclusions: Orthopaedicprocedures had a high risk of mechanical and hematologic complications after using a retrievable VCF.However, mortality was low due to these complications.