Early Experience with the Retrievable OptEase Vena Cava Filter in High-risk Trauma Patients

ObjectivesProphylactic vena cava filters (VCF) are efficient in preventing pulmonary embolism. Filter retrieval avoids the potential long-term complications of permanent VCF. Clinical evaluation was focused on filter-related complications and feasibility of retrieval in high-risk trauma patients.MethodsAnalysis of single-institution consecutive case series of patients who received a prophylactic Optease VCF after multiple trauma between 08/2003 and 12/2004. Data were collected prospectively.ResultsA 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%.ConclusionsRetrieval of the OptEase filter is safe and feasible. Temporary filter placement avoids possible long-term complications of permanent VCF. It is an efficient form of PE prophylaxis when temporary contraindications to anticoagulation are present.