Cavafilter

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Vena Cava Filter (Günther Tulip Filter)

Cavafilter (also Vena-Cava-Filter ) are fine, self-expandable and self-fixing metal constructions, the blood clots that migrate from the veins in the lower half of the body into the pulmonary circulation ( pulmonary embolism ) and can lead to an acute fatal right heart failure in the safer place in the lower one Collect the vena cava ( inferior vena cava ).

Cavafilter are usually not a primary technique for the prevention of pulmonary embolism, but rather useful if a pulmonary embolism recurrence occurs despite adequate medical anticoagulation or if anticoagulation is contraindicated in severe pulmonary embolism. Cava filters are usually placed in the inferior vena cava below the kidney, less often above it and least often in the superior vena cava . However, they do not offer absolute protection against pulmonary embolism.

Today there are permanent and removable (optional) filters. Cavafilters were originally implanted surgically (Mobin-Uddin-Filter 1967, Kim-Ray-Greenfield-Filter 1973), later percutaneously without surgery under local anesthesia via a vein in the groin or neck (Simon-Nitinol-Filter 1977, Bird's nest filter 1980, basket filter 1985, LGM filter).

Based on the results of the PREPIC study (Decousus et al. 2005), which pointed to the long-term problems of chronic venous insufficiency with Cava filters, the trend towards removable filters was strengthened. After a time window of 14 days was previously assumed, filter removal has proven to be possible even after a longer period of time. After the first removable filter (Günther-Tulip-Filter 1992), others followed, such as recovery filters, OptEase filters, ALN filters and Celect filters. Such filters can be removed from the inferior vena cava without surgery under local anesthesia even after a long period of time, provided they are free of larger blood clots and have not grown too firmly into the cavity wall.

literature

  • K. Mobin-Uddin, R. McLean, H. Bolooki, JR Jude: Caval interruption for prevention of pulmonary embolism. Long-term results of a new method. In: Archives of Surgery Volume 99, Number 6, December 1969, pp. 711-715, ISSN  0004-0010 . PMID 5370194 .
  • LJ Greenfield, JR McCurdy, PP Brown, RC Elkins: A new intracaval filter permitting continued flow and resolution of emboli. In: Surgery. Volume 73, Number 4, April 1973, pp. 599-606, ISSN  0039-6060 . PMID 4690105 .
  • JM Neuerburg, RW Günther, D. Vorwerk, RF Dondelinger, H. Jäger, KJ Lackner, HH Schild, GR Plant, FG Joffre, PA Schneider, JH Janssen: Results of a multicenter study of the retrievable Tulip Vena Cava Filter: early clinical experience. In: Cardiovascular and interventional radiology. Volume 20, Number 1, 1997 Jan-Feb, pp. 10-16, ISSN  0174-1551 . PMID 8994718 .
  • PREPIC study group: Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC (Prevention du Risque d'Embolie Pulmonaire par Interruption Cave) randomized study. In: Circulation . Volume 112, Number 3, July 2005, pp. 416-422, ISSN  1524-4539 . doi : 10.1161 / CIRCULATIONAHA.104.512834 . PMID 16009794 .