Authors: V. Čížek; D. Kučera; M. Válka; P. Bartoš; D. Maděřič; M. Pleva Authors‘ workplace: Vaskulární centrum, Vítkovická nemocnice a. s., Ostrava, přednosta prim. MUDr. Dušan Kučera Published in: Vnitř Lék 2009; 55(3): 267-271 Category: 15th Parizek's Days
Pulmonary embolism (PE) is the most serious sign of venous thromboembolism and the 3rd most frequent cause of cardiovascular death. Therapy with anticoagulants represents, among other measures, the mainstay of PE treatment. However, anticoagulant therapy does not prevent recurrence of pulmonary embolism in 3–20% of patients. Most frequently, the source of pulmonary embolism is in venous circulation of lower limbs and pelvis. Interception of the inferior vena cava, originally surgical, later using inferior vena cava filters, is used as a preventive measure. Indications and contraindications of inferior vena cava filters have been redressed and modified several times; the paper provides their list. Older filters used to be retained within the inferior vena cava (so called permanent filters). This was one of the causes of relatively high incidence of complications related to the use of these filters, particularly venous thromboses, as confirmed by so far the only randomised study PREPIC. Consequently, retrievable filters that are currently preferred have been developed. The authors also provide an overview of studies in progress, describe the process of implantation and describe own patient group.
Key words: pulmonary embolism prevention – inferior vena cava filter ligation, plication – inferior vena cava filter – permanent and retrievable filters – indications and contraindication
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