Vena cava filters do not lower mortality rate in most embolism cases

A new study out of MSU reveals when vena cava filters should -- and should not -- be used in patients with a pulmonary embolism. Credit: Courtesy photo

A filter used to block clots from passing from the veins in the legs to the arteries of the lung does not improve mortality rates for most patients suffering a pulmonary embolism. However, if a patient is unstable – in shock or requires a ventilator – filters can save lives.

Furthermore, for unstable with a , it is crucial they receive clot-dissolving medications known as thrombolytic therapy.

The findings come from a set of three research articles on pulmonary embolism treatment published by Michigan State University's Paul Stein in the May edition of the American Journal of Medicine. The findings are based on a study of more than two million patients suffering from the sometimes deadly clots that travel to the lungs and block .

Stein said the studies provide clearer guidance on what treatments are most effective for patients, specifically in regard to vena cava filters and thrombolytic therapy.

"There has been an increase in the use of vena cava filters in the past several years for patients who arrive at a hospital suffering from a pulmonary embolism," said Stein, a professor in osteopathic medical specialties and also director of research at St. Mary Mercy Hospital in Livonia, Mich.

"But it appears the vast majority of filters that are placed in patients with pulmonary embolism may not reduce mortality."

However, he stressed that for the small proportion of patients who arrive at a hospital in an unstable condition, the data suggest mortality can be greatly reduced with a filter.

"These studies provide strong evidence on when filters reduce mortality and when they will not," he said. "Only a small percentage of patients suffering from a pulmonary embolism are in shock or in need of ventilation support, and therefore only a small proportion need a filter."

Stein said for unstable patients it is vital that in addition to using a filter, they receive thrombolytic therapy, which is much less of a risk than the surgical removal of a clot known as an embolectomy.

"Only about a third of unstable patients receive thrombolytic therapy," he said. "The reason may be doctors are afraid that patients will suffer from excessive bleeding. But the data show thrombolytic therapy would save lives if used more frequently."

As for an embolectormy, Stein's team found that in most surgical centers, unless the clinicians are highly specialized and experienced, the mortality rate is high. In most hands, he said, thrombolytic therapy would save more lives.

The findings were from a nationwide government database, the Nationwide Inpatient Sample, and included data on more than two million patients who suffered a pulmonary embolism between 1999 and 2008.

add to favorites email to friend print save as pdf

Related Stories

Clot-busters safe for treating moderate pulmonary embolism

Mar 27, 2012

Pulmonary embolism -- the sudden blockage of an artery in the lung -- is estimated to cause over 100,000 deaths each year in the U.S. Although thrombolytics, or "clot-buster" drugs, are currently reserved to treat only the ...

Clearing the way for detecting pulmonary embolism

Dec 01, 2009

When it comes to diagnosing pulmonary embolism—a sudden blockage in the lung artery that could be deadly if not treated—which technique is the most effective? Research published in the December issue of The Journal of ...

Recommended for you

Two expats die of MERS in Saudi commercial hub

16 hours ago

Two foreigners died of MERS in the Saudi city of Jeddah, the health ministry said Saturday, as fears rise over the spreading respiratory virus in the kingdom's commercial hub.

UAE reports 12 new cases of MERS

16 hours ago

Health authorities in the United Arab Emirates have announced 12 new cases of infection by the MERS coronavirus, but insisted the patients would be cured within two weeks.

Filipino tests negative for Middle East virus

Apr 19, 2014

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

User comments