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Ido Weinberg - One of the best experts on this subject based on the ideXlab platform.
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anticoagulation is associated with decreased Inferior Vena Cava filter related complications in patients with metastatic carcinoma
The American Journal of Medicine, 2017Co-Authors: Syed S Mahmood, Annemarie E Fogerty, Philip Cefalo, Cheryl Mackay, Farhad Abtahian, Michael R. Jaff, Ido WeinbergAbstract:Abstract Objectives Patients with metastatic carcinoma and venous thromboembolism commonly have contraindications to anticoagulation that prompt the use of retrievable Inferior Vena Cava filters. The aim of this study was to compare the pattern of Inferior Vena Cava filter use, anticoagulation management, and development of Inferior Vena Cava filter-related complications in patients with localized versus metastatic carcinoma. Methods We conducted a retrospective cohort study of Inferior Vena Cava filter use at a tertiary referral hospital between January 1, 2009, and December 31, 2011. Including only patients with cancer and carcinomas, both metastatic and localized, we recorded the indications for Inferior Vena Cava filter, postfilter practices including anticoagulation use, filter retrieval rates, and filter-related complications. Results Overall, 154 patients with carcinoma underwent Inferior Vena Cava filter placement. Basic demographics and indication for filter placement were similar between the metastatic and localized groups. Metastatic patients had more filter-related complications (25% vs 11%, P = .03) and underwent filter retrieval less often (31% vs 58%, P = .01). Time to reinitiating anticoagulation was longer in metastatic patients (5.5 vs 2 days, P = .05). In multivariate analysis, metastatic disease was associated with reduced Inferior Vena Cava filter retrieval (odds ratio, 0.3; P = .003). Anticoagulation use was associated with a lower rate of filter-related complications (odds ratio, 0.3; P = .005). Conclusions Patients with metastatic carcinoma with an indwelling Inferior Vena Cava filter had a higher rate of filter-related complications, a lower filter retrieval rate, and a greater median time to initiating anticoagulation. When possible, early reinitiation of anticoagulation may reduce Inferior Vena Cava filter-related complications.
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Inferior Vena Cava filter usage complications and retrieval rate in cancer patients
The American Journal of Medicine, 2014Co-Authors: Farhad Abtahian, Philip Cefalo, Cheryl Mackay, Beau M Hawkins, Nicola J Nasser, David P Ryan, Michael R. Jaff, Ido WeinbergAbstract:Abstract Background Venous thromboembolism contributes significantly to morbidity and mortality in cancer patients. Because cancer patients frequently have contraindications to anticoagulation, Inferior Vena Cava filters are commonly placed. The use, safety, and retrieval of retrievable Inferior Vena Cava filters in cancer patients have not been well studied. Methods A retrospective review of retrievable Inferior Vena Cava filter use at a tertiary referral hospital was conducted between January 1, 2009 and December 31, 2011. Indications for Inferior Vena Cava filter placement, anticoagulation practices, complications, filter retrieval, and patient outcomes were analyzed for patients with and without active cancer and for cancer subtypes, including localized and metastatic cases. Results Of 666 patients receiving retrievable Inferior Vena Cava filters during this time period, 247 (37.1%) had active cancer. Of these, 151 (22.7%) had carcinoma, 92 (13.8%) had sarcoma, and 115 (17.3%) had metastatic disease. Overall, follow-up was available for a median of 401.0 (interquartile range: 107.5-786.5) days. Indwelling filter-related complications occurred in 19.8% of patients without cancer and 17.7% with an active cancer ( P = .50). Patients with cancer were less likely to have the filter retrieved (28.0% vs 42.0%, P Conclusions In a modern cohort of patients undergoing retrievable Inferior Vena Cava filter placement, active diagnosis of cancer is not associated with a significant increase in filter-related complications, but is associated with a reduced rate of filter retrieval.
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Inferior Vena Cava filters
Jacc-cardiovascular Interventions, 2013Co-Authors: Ido Weinberg, John A Kaufman, Michael R. JaffAbstract:Venous thromboembolism is common. Most pulmonary emboli arise as thromboses in the deep veins of the lower extremities and may result in serious complications. Inferior Vena Cava filters (IVCF) are intended to prevent the passage of deep vein thrombosis to the pulmonary arteries. Accepted indications for IVCF placement include the presence of acute venous thromboembolism with inability to administer anticoagulation medication or failure of anticoagulation. Despite these clear indications, IVCF have been commonly placed in patients for primary prevention of pulmonary emboli in patients deemed to be at high risk, along with several other “soft” indications. As a result, IVCF use has been rising over the past 2 decades, especially given the retrievable nature of modern devices. Nonetheless, IVCF are not free of complications, which may occur during implantation and retrieval and while retained in the body. Despite this increase in use, the long-term efficacy remains unclear, and the management of patients with retained filters is often controversial. Finally, filter retrieval in eligible patients is relatively infrequent, suggesting that systems must be in place to improve appropriate filter use and to increase retrieval.
Michael R. Jaff - One of the best experts on this subject based on the ideXlab platform.
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anticoagulation is associated with decreased Inferior Vena Cava filter related complications in patients with metastatic carcinoma
The American Journal of Medicine, 2017Co-Authors: Syed S Mahmood, Annemarie E Fogerty, Philip Cefalo, Cheryl Mackay, Farhad Abtahian, Michael R. Jaff, Ido WeinbergAbstract:Abstract Objectives Patients with metastatic carcinoma and venous thromboembolism commonly have contraindications to anticoagulation that prompt the use of retrievable Inferior Vena Cava filters. The aim of this study was to compare the pattern of Inferior Vena Cava filter use, anticoagulation management, and development of Inferior Vena Cava filter-related complications in patients with localized versus metastatic carcinoma. Methods We conducted a retrospective cohort study of Inferior Vena Cava filter use at a tertiary referral hospital between January 1, 2009, and December 31, 2011. Including only patients with cancer and carcinomas, both metastatic and localized, we recorded the indications for Inferior Vena Cava filter, postfilter practices including anticoagulation use, filter retrieval rates, and filter-related complications. Results Overall, 154 patients with carcinoma underwent Inferior Vena Cava filter placement. Basic demographics and indication for filter placement were similar between the metastatic and localized groups. Metastatic patients had more filter-related complications (25% vs 11%, P = .03) and underwent filter retrieval less often (31% vs 58%, P = .01). Time to reinitiating anticoagulation was longer in metastatic patients (5.5 vs 2 days, P = .05). In multivariate analysis, metastatic disease was associated with reduced Inferior Vena Cava filter retrieval (odds ratio, 0.3; P = .003). Anticoagulation use was associated with a lower rate of filter-related complications (odds ratio, 0.3; P = .005). Conclusions Patients with metastatic carcinoma with an indwelling Inferior Vena Cava filter had a higher rate of filter-related complications, a lower filter retrieval rate, and a greater median time to initiating anticoagulation. When possible, early reinitiation of anticoagulation may reduce Inferior Vena Cava filter-related complications.
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Inferior Vena Cava filter usage complications and retrieval rate in cancer patients
The American Journal of Medicine, 2014Co-Authors: Farhad Abtahian, Philip Cefalo, Cheryl Mackay, Beau M Hawkins, Nicola J Nasser, David P Ryan, Michael R. Jaff, Ido WeinbergAbstract:Abstract Background Venous thromboembolism contributes significantly to morbidity and mortality in cancer patients. Because cancer patients frequently have contraindications to anticoagulation, Inferior Vena Cava filters are commonly placed. The use, safety, and retrieval of retrievable Inferior Vena Cava filters in cancer patients have not been well studied. Methods A retrospective review of retrievable Inferior Vena Cava filter use at a tertiary referral hospital was conducted between January 1, 2009 and December 31, 2011. Indications for Inferior Vena Cava filter placement, anticoagulation practices, complications, filter retrieval, and patient outcomes were analyzed for patients with and without active cancer and for cancer subtypes, including localized and metastatic cases. Results Of 666 patients receiving retrievable Inferior Vena Cava filters during this time period, 247 (37.1%) had active cancer. Of these, 151 (22.7%) had carcinoma, 92 (13.8%) had sarcoma, and 115 (17.3%) had metastatic disease. Overall, follow-up was available for a median of 401.0 (interquartile range: 107.5-786.5) days. Indwelling filter-related complications occurred in 19.8% of patients without cancer and 17.7% with an active cancer ( P = .50). Patients with cancer were less likely to have the filter retrieved (28.0% vs 42.0%, P Conclusions In a modern cohort of patients undergoing retrievable Inferior Vena Cava filter placement, active diagnosis of cancer is not associated with a significant increase in filter-related complications, but is associated with a reduced rate of filter retrieval.
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Inferior Vena Cava filters
Jacc-cardiovascular Interventions, 2013Co-Authors: Ido Weinberg, John A Kaufman, Michael R. JaffAbstract:Venous thromboembolism is common. Most pulmonary emboli arise as thromboses in the deep veins of the lower extremities and may result in serious complications. Inferior Vena Cava filters (IVCF) are intended to prevent the passage of deep vein thrombosis to the pulmonary arteries. Accepted indications for IVCF placement include the presence of acute venous thromboembolism with inability to administer anticoagulation medication or failure of anticoagulation. Despite these clear indications, IVCF have been commonly placed in patients for primary prevention of pulmonary emboli in patients deemed to be at high risk, along with several other “soft” indications. As a result, IVCF use has been rising over the past 2 decades, especially given the retrievable nature of modern devices. Nonetheless, IVCF are not free of complications, which may occur during implantation and retrieval and while retained in the body. Despite this increase in use, the long-term efficacy remains unclear, and the management of patients with retained filters is often controversial. Finally, filter retrieval in eligible patients is relatively infrequent, suggesting that systems must be in place to improve appropriate filter use and to increase retrieval.
Joe B Putnam - One of the best experts on this subject based on the ideXlab platform.
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surgical management of renal cell carcinoma with Inferior Vena Cava tumor thrombus
The Annals of Thoracic Surgery, 1997Co-Authors: Jonathan C Nesbitt, Ernesto R Soltero, Colin P Dinney, Garrett L Walsh, David S Schrump, David A Swanson, Louis L Pisters, Mph Kelly D Willis, Joe B PutnamAbstract:Abstract Background. The optimal management of patients with renal cell carcinoma with Inferior Vena Cava tumor thrombus remains unresolved. Traditional approaches have included resection with or without the use of cardiopulmonary bypass. Chemotherapy has played a minor role except for biotherapeutic agents used for metastatic disease. Methods. From January 1989 to January 1996, 37 patients with renal cell carcinoma and Inferior Vena Cava tumor thrombus underwent surgical resection. The 27 men and 10 women had a median age of 57 years (range, 29 to 78 years). Thirty-six patients presented with symptoms; 21 had hematuria. Distant metastases were present in 12 patients. Tumor thrombi extended to the infrahepatic Inferior Vena Cava (n = 16), the intrahepatic Inferior Vena Cava (n = 16), the suprahepatic Inferior Vena Cava (n = 3), and into the right atrium (n = 2). All tumors were resected by Inferior Vena Cava isolation and, when necessary, extended hepatic mobilization and Pringle maneuver, with primary or patch closure of the Vena cavotomy. Cardiopulmonary bypass was necessary in only 2 patients with intraatrial thrombus. Results. Complications occurred in 11 patients, and 1 patient died 2 days postoperatively of a myocardial infarction (mortality, 2.7%). Twenty patients are alive; overall 2- and 5-year survival rates were 61.7% and 33.6%, respectively. For patients without lymph node or distant metastases (stage IIIa), 2- and 5-year survival rates were 74% and 45%, respectively. The presence of distant metastatic disease (stage IV) at the time of operation did not have a significant adverse effect on survival, as reflected by 2- and 5-year survival rates of 62.5% and 31.3%, respectively. Lymph node metastases (stage IIIc) adversely affected survival as there were no long-term survivors. Conclusions. Resection of an intraCaval tumor thrombus arising from renal cell carcinoma can be performed safely and can result in prolonged survival even in the presence of metastatic disease. In our experience, extracorporeal circulatory support was required only when the tumor thrombus extended into the heart. (Ann Thorac Surg 1997;63:1592–600)
Ba D Nguyen - One of the best experts on this subject based on the ideXlab platform.
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positron emission tomography imaging of renal vein and Inferior Vena Cava tumor thrombus from renal cell carcinoma
Clinical Nuclear Medicine, 2005Co-Authors: Ba D NguyenAbstract:Abstract Renal cell carcinoma is a hypervascular tumor with a high propensity to invade adjacent renal veins and Inferior Vena Cava. Preoperative cross-sectional imaging is very important to detect the presence and characterize the tumor extension. Magnetic resonance, computed tomography, and Doppler ultrasound have been used with success to assess venous tumor thrombus. Although positron emission tomography (PET) is limited in the evaluation of primary urologic malignancy, this imaging modality may help in oncologic staging. The author presents a case of bilateral renal cell carcinoma with F-18 FDG PET demonstration of right renal vein and Inferior Vena Cava tumor invasion.
Syed S Mahmood - One of the best experts on this subject based on the ideXlab platform.
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anticoagulation is associated with decreased Inferior Vena Cava filter related complications in patients with metastatic carcinoma
The American Journal of Medicine, 2017Co-Authors: Syed S Mahmood, Annemarie E Fogerty, Philip Cefalo, Cheryl Mackay, Farhad Abtahian, Michael R. Jaff, Ido WeinbergAbstract:Abstract Objectives Patients with metastatic carcinoma and venous thromboembolism commonly have contraindications to anticoagulation that prompt the use of retrievable Inferior Vena Cava filters. The aim of this study was to compare the pattern of Inferior Vena Cava filter use, anticoagulation management, and development of Inferior Vena Cava filter-related complications in patients with localized versus metastatic carcinoma. Methods We conducted a retrospective cohort study of Inferior Vena Cava filter use at a tertiary referral hospital between January 1, 2009, and December 31, 2011. Including only patients with cancer and carcinomas, both metastatic and localized, we recorded the indications for Inferior Vena Cava filter, postfilter practices including anticoagulation use, filter retrieval rates, and filter-related complications. Results Overall, 154 patients with carcinoma underwent Inferior Vena Cava filter placement. Basic demographics and indication for filter placement were similar between the metastatic and localized groups. Metastatic patients had more filter-related complications (25% vs 11%, P = .03) and underwent filter retrieval less often (31% vs 58%, P = .01). Time to reinitiating anticoagulation was longer in metastatic patients (5.5 vs 2 days, P = .05). In multivariate analysis, metastatic disease was associated with reduced Inferior Vena Cava filter retrieval (odds ratio, 0.3; P = .003). Anticoagulation use was associated with a lower rate of filter-related complications (odds ratio, 0.3; P = .005). Conclusions Patients with metastatic carcinoma with an indwelling Inferior Vena Cava filter had a higher rate of filter-related complications, a lower filter retrieval rate, and a greater median time to initiating anticoagulation. When possible, early reinitiation of anticoagulation may reduce Inferior Vena Cava filter-related complications.