Document Detail

Current indications for preoperative inferior vena cava filter insertion in patients undergoing surgery for morbid obesity.
MedLine Citation:
PMID:  16105398     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pulmonary embolus is a potentially lethal complication in patients undergoing surgery for morbid obesity. In a select group of patients at high risk for venous thromboembolic events (VTE), we have chosen to prophylactically insert inferior vena cava filters via a jugular percutaneous approach. We propose guidelines for preoperative insertion of inferior vena cava filters in patients with clinically significant obesity. METHODS: All patients who underwent preoperative insertion of inferior vena cava (IVC) filters as prophylaxis for pulmonary emboli were reviewed. Data regarding body mass index (BMI), prior history of venous thromboembolism, current anticoagulant usage, as well as other patient data were compiled and analyzed. Additionally, all operative notes were reviewed, and operative data were analyzed and compared. RESULTS: 14 patients underwent preoperative IVC filter placement before gastric bypass. Mean patient age was 49.1 +/- 1.52 years and mean BMI was 56.5 +/- 4.45 kg/m2. No complications occurred due to preoperative filter placement, and no pulmonary emboli occurred in this group. Indications for preoperative IVC filter insertion included prior pulmonary embolus (6), prior deep venous thrombosis (7), and lower extremity venous stasis (1). CONCLUSIONS: Vena caval filter placement in the preoperative period can be undertaken safely in bariatric patients. We recommend that routine preoperative vena caval filter placement should be undertaken in all bariatric patients with prior pulmonary embolus, prior deep venous thrombosis, evidence of venous stasis, or known hypercoagulable state. Possible roles for IVC filter placement in this patient population are expanding as more data is acquired.
W Brent Keeling; Krista Haines; Patrick A Stone; Paul A Armstrong; Michel M Murr; Murray L Shames
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obesity surgery     Volume:  15     ISSN:  0960-8923     ISO Abbreviation:  Obes Surg     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-17     Completed Date:  2005-10-20     Revised Date:  2007-12-05    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  1009-12     Citation Subset:  IM    
University of South Florida, Department of Surgery and Division of Vascular Surgery, Tampa, FL, USA.
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MeSH Terms
Bariatrics / methods*
Middle Aged
Obesity, Morbid / surgery*
Practice Guidelines as Topic
Preoperative Care
Pulmonary Embolism / prevention & control*
Vena Cava Filters*
Comment In:
Obes Surg. 2005 Oct;15(9):1356-7; author reply 1357   [PMID:  16259905 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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