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Ann Fr Anesth Reanim ; 22(9): 809-14, 2003 Nov.
Artículo en Francés | MEDLINE | ID: mdl-14612168

RESUMEN

In the event of proximal venous thrombosis with a risk of pulmonary embolism, contraindications to or complications of anticoagulant treatment are not uncommon in surgical or intensive care units. These are worrying but temporary situations and represent a classic indication for partial interruption of the inferior vena cava, for which permanent caval filters are not usually suitable. Temporary filters are an attractive option in this context, as long as they are safe and stable, can be left in place long enough to permit normalization of the thrombosis and anticoagulation problems and can then be removed in all circumstances, whether or not they have trapped a thrombus while in place. Most temporary filters do not meet all these criteria and nor do permanent filters with a removal option. We tested the new Tempofilter II filter with increased stability, which has a smooth geometry and can be implanted for up to 6 weeks, in 13 patients. We selected two documented cases concerning, firstly, a contraindication to anticoagulants and, secondly, recurrent thrombosis in heparin-induced thrombopenia. In both cases, the filter trapped a thrombus and prevented a pulmonary embolism, which would have been poorly tolerated and difficult to treat. The filters were removed without any difficulty after 4 and 6 weeks. We did not observe any complications related to infection or migration. Monitoring is recommended throughout the implantation period, in order to identify any clots trapped in the filter and to monitor their lysis or non-emboligenic fibrous structure, authorising removal of the filter.


Asunto(s)
Tromboembolia/terapia , Filtros de Vena Cava , Anciano , Anticoagulantes/efectos adversos , Anticoagulantes/uso terapéutico , Femenino , Fracturas del Fémur/complicaciones , Hematoma/cirugía , Heparina/efectos adversos , Heparina/uso terapéutico , Humanos , Desplazamiento del Disco Intervertebral/cirugía , Persona de Mediana Edad , Complicaciones Posoperatorias , Embolia Pulmonar/prevención & control , Recurrencia , Trombocitopenia/sangre , Trombocitopenia/inducido químicamente , Trombocitopenia/complicaciones , Filtros de Vena Cava/efectos adversos
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