Early experience with the retrievable OptEase vena cava filter in high-risk trauma patients

Objectives. Prophylactic vena cava filters (VCF) are efficient in preventing pulmonary embolism. Filter retrieval avoids file potential long-term complications of permanent VCF. Clinical evaluation was focused on filter-related complications and feasibility of retrieval in high-risk trauma patients. Methods. Analysis of single-institution consecutive case series of patients who received a prophylactic Optease VCF after multiple trauma between 0812003 and 12/2004. Data were collected prospectively. Results. A total of 37 OptEase filters were inserted prophylactically after multiple trauma (median patient age 35 years, range, 17-73 years, median ISS 41, range, 17-59). All patients had contraindications for pharmacological prophylaxis for thromboembolic events. 32 filters (86%) were retrieved after 16 days (range, 7-25 days). 12 of 33 filters (36%) demonstrated trapped clots/thrombosis within the filter structure on pre-retrieval cavography. Two patients received anticoagulation before filter retrieval due to filter thrombosis (6%). Symptomatic PE was observed in 1 patient (3%) 5 days after VCF retrieval. Minor caudal filter migration was observed in 1 patient (3%). Overall mortality was 3%. Conclusions. Retrieval of the OptEase filter is safe and feasible. Temporary filter placement avoids possible long-term complications of permanent VCF. It is all efficient form of PE prophylaxis when temporary contraindications to anticoagulation are present.