Results of Open Surgery in Patients with Late Complications after the Implantation of the Inferior vena Cava Filters

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Background — the objective of the present study was to assess the results of the open surgical interventions on the patients with the late complications following the implantation of the inferior cava filters (ICF) who could not be treated by the endovascular methods. Material and methods. The study included 37 patients at the age from 18 to 62 years presenting with the late life-threatening complications of implantation of ICF. The filtering devices remained in the inferior vena cava for the period from 1 month to 30 years (mean 11 months) before the admission to the hospital. The principal indications for the open surgical interventions on the inferior vena cava included the incorrect position of the ICF, the life-threatening conditions associated with the defragmentation of ICF, the penetration of the parts of ICF into the para-caval tissues, duodenum, aorta, and liver, large free-floating thrombosisi developing on the cranial surface of the ICF, the destruction of the ICF and migration of its fragments, the failure to remove the «retrievable» model of the ICF the presence of which either created a risk of intravital complications or significantly decreased the patients’ quality of life. The open surgical interventions were used in the cases of technical impossibility of the application of the endovascular methods and/or their low effectiveness as well as in the patients having indications for the urgent operation. In two cases, we decided to leave the ICF untouched. Results. A total of 35 inferior cava filters of various designs were removed as a result of the surgical interventions. Two patients reported the formation of retroperitoneal hematomas, in two other cases we found the parietal thrombosis of inferior vena cava. The conservative treatment of the complications proved successful. No mortality was documented. Conclusion. The open surgical intervention on the inferior vena cava provides an efficient and safe tool for the removal of the ICF in the cases of postoperative complications.

Keywords:

postthrombotic syndrome

inferior vena cava

inferior cava filter

laparotomy

open removal

Authors:

Kirienko A.I.

Russian National Research Medical University nabbed after N.I. Pirogov, Moscow, Russia

SPIN RSCI: 8319-5682
Scopus AuthorID: 7007011716
ResearcherID: AAA-5162-2019
ORCID: 0000-0001-8792-1694

Andriiashkin V.V.

Kafedra fakul'tetskoĭ khirurgii im. S.I. Spasokukotskogo Rossiĭskogo gosudarstvennogo meditsinskogo universiteta im. N.I. Pirogova, Moskva

Ivanov V.V.

N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russia, Moscow, Russia

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