Kamlesh Uttamchand Kukreja MD, Presenter: Nothing to Disclose

Marcia Komlos MD, Abstract Co-Author: Nothing to Disclose

Manish Natvarlal Patel DO, Abstract Co-Author: Nothing to Disclose

Neil David Johnson MD, Abstract Co-Author: Nothing to Disclose

John Miras Racadio MD, Abstract Co-Author: Research collaboration, Koninklijke Philips Electronics NV Speaker, Koninklijke Philips Electronics NV Medical Advisory Board, Koninklijke Philips Electronics NV

Because of the high morbidity of thromboembolic disease and the difficultly of anticoagulation in some patients, inferior vena cava (IVC) filters are used as an alternative prophylactic measure for prevention of pulmonary embolism (PE). Concern about the long term morbidity of permanent filters has increased interest in retrievable filters, but experience with their use in children has been limited. We review our experience with IVC filters in pediatric population.

Retrospective review of all children who underwent placement and/or retrieval of IVC filters over a 10 year period at our pediatric institution was performed.

Patient population included 11 females and 7 males from 11 to 18 years of age (mean 15 years). Indications for filter placement included deep venous thrombosis (DVT) and PE, contraindications for anticoagulation and failed anticoagulation. 17 filters were successfully inserted at our institution. One child had the filter (Gunther tulip) inserted at an outside institution which was retrieved at our institute. Before 2003, 6 filters were placed, all were permanent (2 Greenfield and 4 trapease). Since the availability of retrievable filters at our institute (2003), 9 of 11 filters placed were retrievable. The 9 retrievable included 8 Gunther tulip (G-T) and 1 recovery; the 2 permanent were 1 trapease and 1 venatech. 4 G-T and 1 recovery filter were successfully retrieved. No immediate complications occurred during placement or retrieval. The mean interval time between placement and retrieval was 74 days. Filter retrieval was not attempt in 4 children: 2 due to recurrent thrombotic disease, 1 lost to follow-up and 1 is being followed for DVT. 1 G-T filter could not be retrieved due to long indwell time (356 days).

Placement and retrieval of IVC filters can be safely and successfully performed in children. We noted an increase in the use of IVC filters in children at our institution since the availability of retrievable filters at our institute. Our experience with retrievable IVC filters has been encouraging, allowing us to offer a safe, effective temporary prophylatic measure for children at high risk of PE or with contraindications to anticoagulation.  

1. Management of pulmonary embolism in children.

Kukreja, K, Komlos, M, Patel, M, Johnson, N, Racadio, J, Vena Caval Filter in Children: 10-year Experience at a Single Institution.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6019029.html