Journal of In Silico & In Vitro Pharmacology

Introduction

Venous Thromboembolism (VTE), Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)) is a preventable medical illness that is frequently misdiagnosed and fatal. VTE has a considerable impact on morbidity, death, and healthcare costs all around the world. DVT occurs in the lower extremity's deep veins, and pelvic veins are the primary cause of all clinically significant PEs (90%).

The major reason for treating DVT is to avoid serious PE. The impact of a PE is determined by the baseline cardiopulmonary reserve and the amount of the pulmonary vascular bed's total cross-sectional area reduction. Acute PE causes a rise in Pulmonary Artery Pressure (PAP), which adds to further pulmonary artery vasoconstriction and deteriorating hemodynamics. In the vast majority of cases, the indications for IVC filter insertion are only transitory, and the filter should be withdrawn as soon as the symptoms go away to avoid repeated DVT or IVC thrombus formation. With advancements in technology, a new IVC filter can be employed as a retrieval device and then removed once the risk of PE has passed. Clinicians are becoming more comfortable with IVC filters, and the indications for filter insertion are continuing to grow and evolve.

Methods

A database review of medical records from patients who had an IVC filter implanted. Between August 2017 and August 2020, the study was conducted at Almoosa Hospital in Alhasa, Saudi Arabia. Almoosa Hospital in Alhasa is the largest tertiary referral institution in Saudi Arabia's Eastern region, with a capacity of 300 beds. We looked at the following factors for patients who had IVC filters: indications for filter implantation filter type, filter retrieval rate, anticoagulation, complications, and post-discharge follow-up. The IVC filter was placed within 7 days of an acute VTE incident, and the reason for doing so was documented. Thorough history taking, complete physical examination including vital signs, chest X-ray, D-dimer, duplex venous system, Eco Cardiogram (ECG), complete blood count, renal and liver functions tests, and INR were conducted on all patients included in the study. All patients with established PE underwent echocardiography to test pulmonary artery pressure and right ventricular function in order to identify individuals with insufficient cardiopulmonary reserve. The majority of cases were referred for IVC filter insertion from the medical ward, with fewer cases referred from critical care. There was no death, and most of the patients were released home in their pre-critical illness condition, with the exception of four patients who required long-term ICU care due to additional comorbidities. Fluoroscopy wiped out an interventional suite is that the commonest imaging modality used.

After sterile preparation of the access site, local lidocaine infusion was given, followed by a little incision, and a catheter was inserted under fluoroscopic guidance. The filter was pushed along the catheter and deployed.

Conclusion

When used properly, IVC filter implantation is a safe and effective means of preventing potentially fatal PE caused by deep venous thrombosis in the pelvis and lower extremities.