Vena Cava Filters in Spinal Cord Injuries: Evolving Technology

J Spinal Cord Med, 2006 · DOI: · Published: January 1, 2006

Spinal Cord Injury Cardiovascular Science

Simple Explanation

Deep vein thrombosis (DVT) is common in people with spinal cord injuries (SCI). Vena cava filters (VCFs) are sometimes used to prevent pulmonary embolism (PE) in these patients. VCFs are recommended when blood thinners are not an option or have failed to prevent blood clots. Newer VCFs can be removed once the risk of blood clots decreases. This article reviews the use of VCFs in SCI patients, discussing their effectiveness, risks, and the availability of removable filters.

Study Duration

Not specified

Participants

Literature review

Evidence Level

Not specified

Key Findings

1
VCFs are effective at preventing pulmonary embolism from lower-extremity DVT, with a success rate of about 98%.
2
The use of prophylactic VCFs has increased, particularly in trauma patients, including those with SCI, due to improved safety and ease of use.
3
Retrievable VCFs offer the benefit of preventing PE during the high-risk period, while potentially avoiding long-term complications associated with permanent filters.

Research Summary

Asymptomatic deep venous thrombosis (DVT) has been reported in 60% to 100% of persons with spinal cord injury (SCI). Retrievable VCFs are a safe, feasible option for secondary prophylaxis of VTE in patients with SCI. Objective criteria for temporary and permanent placement need to be defined. Pharmacologic (LMWHs) and mechanical techniques (IPC) remain the primary prophylaxis against VTE. However, in the acute setting, the consideration of VCFs in patients with early contraindication to even prophylactic doses of LMWH may be reasonable.

Practical Implications

Secondary VTE prophylaxis

Retrievable VCFs provide a safe and feasible option for secondary VTE prophylaxis in SCI patients.

Individualized approach

Consider VCF placement in SCI patients with high cervical lesions (C2-C3), poor cardiopulmonary reserve, or IVC thrombus despite anticoagulation.

Future Research

Further research is needed to evaluate the impact of filter retrieval on outcomes and long-term complications.

Study Limitations

1
Lack of large, multicenter trials to demonstrate the benefit of retrievable VCFs.
2
Need for objective criteria to determine the appropriate timing of VCF removal.
3
Limited data on the long-term outcomes of retrievable VCFs compared to permanent filters.

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