Are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery?

Background: In high-risk patients, common prophylaxis may be insufficient to prevent thromboembolic events after orthopaedic procedures. In this scenario, a retrievable vena cava filter (VCF) could be considered as an alternative, although it's use remains controversial. Therefore, we asked: (1...

Descripción completa

Detalles Bibliográficos
Autores principales: Slullitel, Pablo A. I., Posadas-Martinez, María Lourdes, Díaz Dilernia, Fernando, Stagnaro, Joaquín, Revah, Mariano, Rojas, Liliana, Buttaro, Martín A., Slullitel, Gastón A.
Formato: Artículo revista
Lenguaje:Inglés
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2018
Materias:
filtro de vena cava removible
enfermedad tromboembólica
cirugía ortopédica
trombosis venosa profunda
embolia pulmonar
retrievable vena cava filter
thromboembolic disease
orthopedic surgery
deep vein thrombosis
pulmonary embolism
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/17746
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
id I10-R327-article-17746
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
language Inglés
format Artículo revista
topic filtro de vena cava removible
enfermedad tromboembólica
cirugía ortopédica
trombosis venosa profunda
embolia pulmonar
retrievable vena cava filter
thromboembolic disease
orthopedic surgery
deep vein thrombosis
pulmonary embolism
spellingShingle filtro de vena cava removible
enfermedad tromboembólica
cirugía ortopédica
trombosis venosa profunda
embolia pulmonar
retrievable vena cava filter
thromboembolic disease
orthopedic surgery
deep vein thrombosis
pulmonary embolism
Slullitel, Pablo A. I.
Posadas-Martinez, María Lourdes
Díaz Dilernia, Fernando
Stagnaro, Joaquín
Revah, Mariano
Rojas, Liliana
Buttaro, Martín A.
Slullitel, Gastón A.
Are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery?
topic_facet filtro de vena cava removible
enfermedad tromboembólica
cirugía ortopédica
trombosis venosa profunda
embolia pulmonar
retrievable vena cava filter
thromboembolic disease
orthopedic surgery
deep vein thrombosis
pulmonary embolism
author Slullitel, Pablo A. I.
Posadas-Martinez, María Lourdes
Díaz Dilernia, Fernando
Stagnaro, Joaquín
Revah, Mariano
Rojas, Liliana
Buttaro, Martín A.
Slullitel, Gastón A.
author_facet Slullitel, Pablo A. I.
Posadas-Martinez, María Lourdes
Díaz Dilernia, Fernando
Stagnaro, Joaquín
Revah, Mariano
Rojas, Liliana
Buttaro, Martín A.
Slullitel, Gastón A.
author_sort Slullitel, Pablo A. I.
title Are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery?
title_short Are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery?
title_full Are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery?
title_fullStr Are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery?
title_full_unstemmed Are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery?
title_sort are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery?
description Background: In high-risk patients, common prophylaxis may be insufficient to prevent thromboembolic events after orthopaedic procedures. In this scenario, a retrievable vena cava filter (VCF) could be considered as an alternative, although it's use remains controversial. Therefore, we asked: (1) what is the overall mechanical complication rate associated with the use of retrievable VCFs in orthopaedic surgery?, (2) what is the association with thromboembolic disease (TED) recurrence, post-thrombotic syndrome and/or major bleeding according to different surgical characteristics?, (3) What is the overall mortality rate attributed to VCF use?Methods: We retrospectively analyzed a cohort of 68 patients who underwent orthopaedic surgery with a previous diagnosis of TED, in whom a retrievable VCF was placed. Permanent filters were excluded. We studied the filter’s mechanical complications and considered as possible outcomes death and 3 hematologic complications: TED recurrence, post-thrombotic syndrome and major bleeding. To estimate association with risk factors, we subclassified surgeries into 5 groups: 1, arthroplasty/non-arthroplasty; 2, primary/revision; 3, elective/urgent; 4, oncologic/non-oncologic; 5, preoperative/postoperative filter.Results: Mechanical complications were 16% and required a filter revision. Sixty-four percent of the revised VCFs developed a mechanical failure and could not be retrieved. Overall prevalence of TED recurrence, post-thrombotic syndrome and hemorrhage was 33%, 15% and 4.5%, respectively. Spinal surgeries were a risk factor for developing TED recurrences.  Only 4% of patients died of a TED recurrence.Conclusions: Orthopaedic procedures had a high risk of mechanical and hematologic complications after using a retrievable VCF. However, mortality was low due to these complications.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2018
url https://revistas.unc.edu.ar/index.php/med/article/view/17746
work_keys_str_mv AT slullitelpabloai arethereanyriskfactorsfordevelopingcomplicationswiththeuseofretrievablevenacavafiltersinorthopaedicsurgery
AT posadasmartinezmarialourdes arethereanyriskfactorsfordevelopingcomplicationswiththeuseofretrievablevenacavafiltersinorthopaedicsurgery
AT diazdilerniafernando arethereanyriskfactorsfordevelopingcomplicationswiththeuseofretrievablevenacavafiltersinorthopaedicsurgery
AT stagnarojoaquin arethereanyriskfactorsfordevelopingcomplicationswiththeuseofretrievablevenacavafiltersinorthopaedicsurgery
AT revahmariano arethereanyriskfactorsfordevelopingcomplicationswiththeuseofretrievablevenacavafiltersinorthopaedicsurgery
AT rojasliliana arethereanyriskfactorsfordevelopingcomplicationswiththeuseofretrievablevenacavafiltersinorthopaedicsurgery
AT buttaromartina arethereanyriskfactorsfordevelopingcomplicationswiththeuseofretrievablevenacavafiltersinorthopaedicsurgery
AT slullitelgastona arethereanyriskfactorsfordevelopingcomplicationswiththeuseofretrievablevenacavafiltersinorthopaedicsurgery
AT slullitelpabloai existenfactoresderiesgoparadesarrollarcomplicacionesconelusodefiltrosdevenacavaremoviblesencirugiasortopedicas
AT posadasmartinezmarialourdes existenfactoresderiesgoparadesarrollarcomplicacionesconelusodefiltrosdevenacavaremoviblesencirugiasortopedicas
AT diazdilerniafernando existenfactoresderiesgoparadesarrollarcomplicacionesconelusodefiltrosdevenacavaremoviblesencirugiasortopedicas
AT stagnarojoaquin existenfactoresderiesgoparadesarrollarcomplicacionesconelusodefiltrosdevenacavaremoviblesencirugiasortopedicas
AT revahmariano existenfactoresderiesgoparadesarrollarcomplicacionesconelusodefiltrosdevenacavaremoviblesencirugiasortopedicas
AT rojasliliana existenfactoresderiesgoparadesarrollarcomplicacionesconelusodefiltrosdevenacavaremoviblesencirugiasortopedicas
AT buttaromartina existenfactoresderiesgoparadesarrollarcomplicacionesconelusodefiltrosdevenacavaremoviblesencirugiasortopedicas
AT slullitelgastona existenfactoresderiesgoparadesarrollarcomplicacionesconelusodefiltrosdevenacavaremoviblesencirugiasortopedicas
first_indexed 2024-09-03T20:58:37Z
last_indexed 2024-09-03T20:58:37Z
_version_ 1809210008250875904
spelling I10-R327-article-177462024-08-27T18:20:48Z Are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery? ¿Existen factores de riesgo para desarrollar complicaciones con el uso de filtros de vena cava removibles en cirugías ortopédicas Slullitel, Pablo A. I. Posadas-Martinez, María Lourdes Díaz Dilernia, Fernando Stagnaro, Joaquín Revah, Mariano Rojas, Liliana Buttaro, Martín A. Slullitel, Gastón A. filtro de vena cava removible enfermedad tromboembólica cirugía ortopédica trombosis venosa profunda embolia pulmonar retrievable vena cava filter thromboembolic disease orthopedic surgery deep vein thrombosis pulmonary embolism Background: In high-risk patients, common prophylaxis may be insufficient to prevent thromboembolic events after orthopaedic procedures. In this scenario, a retrievable vena cava filter (VCF) could be considered as an alternative, although it's use remains controversial. Therefore, we asked: (1) what is the overall mechanical complication rate associated with the use of retrievable VCFs in orthopaedic surgery?, (2) what is the association with thromboembolic disease (TED) recurrence, post-thrombotic syndrome and/or major bleeding according to different surgical characteristics?, (3) What is the overall mortality rate attributed to VCF use?Methods: We retrospectively analyzed a cohort of 68 patients who underwent orthopaedic surgery with a previous diagnosis of TED, in whom a retrievable VCF was placed. Permanent filters were excluded. We studied the filter’s mechanical complications and considered as possible outcomes death and 3 hematologic complications: TED recurrence, post-thrombotic syndrome and major bleeding. To estimate association with risk factors, we subclassified surgeries into 5 groups: 1, arthroplasty/non-arthroplasty; 2, primary/revision; 3, elective/urgent; 4, oncologic/non-oncologic; 5, preoperative/postoperative filter.Results: Mechanical complications were 16% and required a filter revision. Sixty-four percent of the revised VCFs developed a mechanical failure and could not be retrieved. Overall prevalence of TED recurrence, post-thrombotic syndrome and hemorrhage was 33%, 15% and 4.5%, respectively. Spinal surgeries were a risk factor for developing TED recurrences.  Only 4% of patients died of a TED recurrence.Conclusions: Orthopaedic procedures had a high risk of mechanical and hematologic complications after using a retrievable VCF. However, mortality was low due to these complications. Introducción: En pacientes sometidos a cirugía ortopédica y con antecedente de Enfermedad tromboembolica, la profilaxis común suele ser insuficiente para prevenir eventos tromboembólicos. Los filtros de vena cava (FVC) removibles pueden considerarse una alternativa. Objetivos: Estimar la tasa de complicaciones hematológicas, mecánicas y muertes asociadas al uso de FVC removibles en cirugía ortopédica. Métodos: Se diseñó una cohorte retrospectiva de pacientes con historia previa de Enfermedad tromboembolica (ETE) sometidos a procedimientos ortopédicos que requirieron FVC removible, entre el 2006-2014 en el servicio de ortopedia del Hospital Italiano de Buenos Aires. Se definió complicación asociada al FVC a las complicaciones mecánicas, hematológicas (recurrencia de ETE, síndrome postrombotico  y sangrado mayor) y muerte. Para estimar la asociación con factores de riesgo, subclasificamos a las cirugías en 5 grupos: 1, artroplastia/no artroplastia; 2, primaria/revisión; 3, electiva/urgente; 4, oncológica/no oncológica; 5, filtro pre/postoperatorio. Resultados: Se incluyeron 68 pacientes, de los cuales 31 presentaron algún tipo de complicación. Las complicaciones mecánicas ostentaron un 16%, precisando de una revisión del filtro. 64% de los filtros revisados fallaron mecánicamente y no pudieron ser extraídos. Las tasas de recurrencia de ETE, síndrome postrombotico  y sangrado mayor fueron del 33%, 15% y 4.5%, respectivamente. Las cirugías espinales presentaron un mayor riesgo de recurrencia de ETE. La mortalidad global fue del 28% y  4% asociada a recurrencia de ETE. Conclusiones: Las cirugías ortopédicas exhibieron un riesgo elevado de complicaciones mecánicas y hematológicas luego de usar un FVC removible. Empero, la mortalidad debido a dichas complicaciones fue baja. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2018-07-27 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf image/png application/vnd.openxmlformats-officedocument.wordprocessingml.document image/png image/tiff image/tiff application/msword application/msword https://revistas.unc.edu.ar/index.php/med/article/view/17746 10.31053/1853.0605.v75.n2.17746 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 75 No. 2 (2018); 119-127 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 75 Núm. 2 (2018); 119-127 Revista da Faculdade de Ciências Médicas de Córdoba; v. 75 n. 2 (2018); 119-127 1853-0605 0014-6722 10.31053/1853.0605.v75.n2 eng https://revistas.unc.edu.ar/index.php/med/article/view/17746/20618 https://revistas.unc.edu.ar/index.php/med/article/view/17746/26626 https://revistas.unc.edu.ar/index.php/med/article/view/17746/26627 https://revistas.unc.edu.ar/index.php/med/article/view/17746/26628 https://revistas.unc.edu.ar/index.php/med/article/view/17746/26629 https://revistas.unc.edu.ar/index.php/med/article/view/17746/26630 https://revistas.unc.edu.ar/index.php/med/article/view/17746/26632 https://revistas.unc.edu.ar/index.php/med/article/view/17746/26699 Derechos de autor 2018 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0

Ejemplares similares