VENA CAVAL FILTRATION (VCF) IN AN ONCOLOGIC POPULATION (MEETING ABSTRACT)

Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.

VENA CAVAL FILTRATION (VCF) IN AN ONCOLOGIC POPULATION (MEETING ABSTRACT)

Proc Annu Meet Am Soc Clin Oncol; 10:A1197 1991. Unique Identifier : AIDSLINE ICDB/91672534
Wagman L; Galli R; City of Hope Natl. Medical Center, Duarte, CA 91010

Abstract: The use of aggressive palliative modalities such as VCF must be cautiously analyzed in patients (pts) with cancer. From September 1981 until September 1989, the placement indications, preexisting conditions, type of device used, complications, efficacy and survival in 34 pts (31 with cancer [91%], 1 AIDS and 2 benign disease) with VCF were retrospectively reviewed. At the time of VCF, 22 of the 31 cancer pts had metastatic disease. 33 of 34 pts had evidence of pelvic or lower extremity deep venous thrombosis and 1 pt had IVC leiomyomatosis. 52% of the devices were placed because of a contraindication to anticoagulation (ACG), 12% for complications of ACG, 12% for pulmonary embolism (PE) while on ACG, 15% for recurrent PE while on ACG, 9% as PE prophylaxis. Greenfield filters (GF) were used in 26 (76%) of the 34 pts; 4 had Mobin-Uddin umbrellas, 2 had balloons and 2 had transcaval clips. GF have been used exclusively since 1985 and all were placed via the jugular approach. The presence of tumor mass or a narrowing of the vena cava required placement of 4 suprarenal GF, without untoward renal sequelae. Complications of all procedures included wound infection (6%), misplacement in renal vein (3%) and suspected recurrent PE (3%). 3 pts died during the same admission as VCF (none as a result of VCF placement) and 10 are currently alive. Pts with cancer survived an av of 532 days (d) after VCF (median 456 d, range 1-3220 d). In conclusion, VCF can be performed with minimal morbidity (6%), no mortality and high success rate (97%) in a cancer population. The mean survival of almost 18 mo makes this procedure reasonable in this selected group.

Keywords: Acquired Immunodeficiency Syndrome/PHYSIOPATHOLOGY Female Human Leiomyoma/PHYSIOPATHOLOGY Neoplasms/*PHYSIOPATHOLOGY Palliative Care Postoperative Complications Retrospective Studies Thrombosis/SURGERY Uterine Neoplasms/PHYSIOPATHOLOGY *Vena Cava Filters ABSTRACT
911030
M91A1116

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