THE USE OF THE ZONTIK CAVA FILTER FOR TEMPORARY IMPLANTATION TO THE INFERIOR VENA CAVA

V.I. Prokubovsky, V.P. Burov, S.A. Kapranov, A.N. Balan
S.I. Spasokukotsky Chair of Faculty Surgery,Russian State Medical University,
Moscow, Russia

The authors review the potential for the use of the Zontik retrievable cava filter (CF) for temporary implantation. In the course of their observations, the CF was to be received by 68 patients for the time needed for the treatment of floating thrombi in the inferior vena cava and its tributaries using thrombectomy, thrombolysis or anticoagulants. In 10 patients, the CF was implanted in view of the risk of pulmonary thromboembolism (PTE) during and after obstetric-gynecological and orthopedic operations carried out in the presence of deep venous thrombosis of the lower limbs. After elimination of the risk of PTE the CF was retrieved in 38 (48.7%) patients over the period 2 to 64 days; 4 patients declined filter retrieval; in 3 patients, the procedure ended in failure. In view of the risk of PTE the CF, was left for permanent implantation in 33 patients. Of these, in 8 patients it was left due to embolism to the filter and in 8 patients due to its thrombosis. One patient developed PTE which prompted CF retrieval on the second day following implantation.Thirty patients were examined over the period 12 to 62 months after CF retrieval. No signs of PTF were detected, the inferior vena cava was patent.Based on their own experience the authors investigate the conditions required for temporary implantation of the CF and the indications for its use, factors providing for the minimal risk of the recurrence of venous thrombosis and PTF after filter retrieval, and the possibilities of a broader practical use of the technique. They believe that temporary implantation of the CF is the most prospective trend in endovascular prevention of PTE.

KEY WORDS: cava filter, temporary implantation, pulmonary artery embolism, prevention, venous thrombosis.

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