RESUMEN
The authors report their experience with the temporary placement of inferior vena caval filters to prevent pulmonary embolism in acute deep venous thrombosis patients. Twenty devices--6 Filcard and 4 Bruneau type--were positioned and left in situ over a time period ranging 4 to 14 days (mean: 9.8). In one patient the filter was positioned and no adjunctive medical therapy given to provide protection before nephrectomy; five patients were treated with i.v. heparin that provided no vein patency but prevented disease progression. Due to failure in positioning infusion guide catheters within the thrombus, four patients were submitted to fibrinolysis and heparin therapy: when the thrombus stabilized on angiographic images, heparin alone was administered and then followed by orally administered coumarin anticoagulants. In two cases partial thrombosis resolution was achieved, but with no significant improvement in patency rate. Ten patients underwent in situ fibrinolysis: six of them exhibited moderate improvement in femoroiliac axis patency and in three patients the inferior vena cava was successfully recanalized. No patient had any clinical evidence of pulmonary embolism. One case had cranial thrombus spread which was successfully treated with fibrinolysis. In our opinion, to control possible thrombotic involvement of the device, the patients candidate for temporary inferior vena caval filters must be easy to "manage" and exhibit no contraindications fibrinolysis and anticoagulant treatment.