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

May 31, 2012
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.

Explore further: 'Clot-busters' no more effective than traditional therapy in treating lung blood clots

Related Stories

Clot-busters safe for treating moderate pulmonary embolism

March 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 ...

Recommended for you

Monkeys in Asia harbor virus from humans, other species

November 19, 2015

When it comes to spreading viruses, bats are thought to be among the worst. Now a new study of nearly 900 nonhuman primates in Bangladesh and Cambodia shows that macaques harbor more diverse astroviruses, which can cause ...

One-step test for hepatitis C virus infection developed

November 14, 2015

UC Irvine Health researchers have developed a cost-effective one-step test that screens, detects and confirms hepatitis C virus (HCV) infections. Dr. Ke-Qin Hu, director of hepatology services, will present findings at the ...

Computer model reveals deadly route of Ebola outbreak

November 10, 2015

Using a novel statistical model, a research team led by Columbia University's Mailman School of Public Health mapped the spread of the 2014-2015 Ebola outbreak in Sierra Leone, providing the most detailed picture to date ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.