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• W2914732642 abstract "Although anticoagulation remains the mainstay of treatment for deep venous thrombosis (DVT), the utilization of vena cava interruption devices in patients in whom treatment has failed or in whom anticoagulation is contraindicated remains safe and effective. In this regards, Greenfield and TrapEase filters are arguably the most popular filtration devices among the ones that are currently in use. The Greenfield filter, which is available in a 12F to 14F introducer, has been in use for >30 years and has been well studied. The TrapEase filter, which is only 6F, has been available for fewer years, with limited number of studies. Despite the popularity of these filtration devices, there are no good guidelines in place to help determine which filter to use in any given situation. Therefore, in this study we prospectively compared the clinical outcomes between the above-mentioned filters in a randomized fashion. Between July 2006 and November 2008, 156 patients (63 men, 93 women), with a mean age of 75 ± 13 (SD) years (range, 38-101 years) were randomized to either Greenfield (n = 84) or TrapEase (n = 72) IVC filters. During this same period, 349 patients (143 men, 206 women), who were a mean age of 75 ± 15 years (range 24-96 years), were not randomized. Other demographics were 26.9% malignancy and 17.3% pulmonary embolism (PE) in the randomized group vs 16.9% malignancy and 17.2% PE in the nonrandomized group. The inclusion criteria were high-risk procedure for thromboembolism, contraindication to anticoagulation, failed anticoagulation, and PE. All 156 filters were inserted in the infrarenal position by one group of surgeons at one institution using angiographic guidance. Follow-up consisted of serial lower extremity and iliac/IVC duplex imaging (78.2%) at postoperative day 1, the first week, every 3 months for the first year, and every 6 months for the second year, as well as clinical evaluation and clinic visits. Indications for filter placement in the randomized group were gastrointestinal bleeding in 37, intracranial hemorrhage in 12, free-floating clot in 19, failure of anticoagulation in 29, PE in 27, prophylactic in 4, and others in 32. Indications for the nonrandomized group were gastrointestinal bleeding in 78, intracranial hemorrhage in 26, free-floating clot in 31, failure of anticoagulation in 51, PE in 60, prophylactic in 31, and others in 77. During a mean follow-up of 10 ± 9 months (range, 0-33 months), symptomatic IVC/iliac thrombosis developed in five patients (6.94%) in the TrapEase group but in none in the Greenfield group (P = .019). Overall mortality was 32.7% (51 patients), and 30-day mortality was 13.5% (21 patients: 10 in TrapEase and 11 in Greenfield group). The study was initially designed to recruit 360 patients but was prematurely concluded due the results. There is a higher rate of symptomatic IVC filter thrombosis associated with TrapEase filter placement." @default.
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• W2914732642 date "2010-03-01" @default.
• W2914732642 modified "2023-09-26" @default.
• W2914732642 title "Prospective Randomized Study Comparing the Clinical Outcomes Between Inferior Vena Cava Greenfield and TrapEase Filters" @default.
• W2914732642 doi "https://doi.org/10.1016/j.jvs.2009.11.024" @default.
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