The use of inferior vena cava filter as a treatment modality for massive XXXX . A case series and review of pathophysiology.

@entity1 @entity548 @entity26 @entity1151 @entity891 @entity519 @entity358 @entity887 @entity221
The use of inferior vena cava (IVC) filter for massive @entity1151 ( @entity1151 ) with cardiopulmonary instability has not been clinically studied. We present a case series of six such @entity1 who received an IVC filter with anticoagulation rather than thrombolysis because of high risk of @entity548 . @entity358 was considered, but was not possible for a variety of individual clinical situations. These six hospitalized @entity1 prospectively followed during their admission. They were triaged to three medical intensive care units (ICUs) and one surgical ICU in three university teaching hospitals. One @entity1 was transferred from another institution. All six @entity1 had severe @entity519 and tenuous cardiopulmonary status. All required high inspiratory @entity26 and hemodynamic support; two required mechanical ventilation and vasopressors. An IVC filter was placed emergently and anticoagulation was started immediately All six @entity1 had @entity358 (PTE) on anticoagulation while the IVC filter prevented further @entity1151 . All six @entity1 were discharged home in their pre-critical @entity221 state. None ofthe @entity1 suffered complications from this therapy and had excellent @entity891 . The IVC filter placement prevented further major @entity887 while the PTE resolved with anticoagulation. An IVC filter should be considered as an adjunct to anticoagulation therapy for those @entity1 with massive @entity1151 and cardiopulmonary instability who are not candidates for thrombolysis, and @entity358 is not readily available or is of very high risk.
