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IVCF without heparin lowered complication rates after TJA
Patients who received inferior vena cava filter without heparin after total joint arthroplasty experienced significantly lower complication rates compared with patients who received both inferior vena cava filter and inferior vena heparin, according to study results.
Researchers retrospectively identified 294 patients with documented, symptomatic pulmonary embolism (PE) that occurred within 90 days of surgery. All patients received postoperative treatment with warfarin and were assigned to receive either inferior vena cava filter (IVCF) and unfractionated intravenous heparin (group 1), IVCF only (group 2), unfractionated intravenous heparin only (group 3) or no treatment (group 4).
After total joint arthroplasty (TJA), PE occurred at a mean of 2.3 days, and IVCFs were inserted at a mean of 0.3 days after PE diagnosis. No PE recurrence was seen after treatment in any of the groups, and no complications directly related to IVCF insertion were reported. Within 6 months postoperatively, group 1 experienced the highest rate of complications, whereas group 2 experienced the lowest. Two patients died within 6 months following surgery.
Patients who received heparin experienced a significantly longer length of stay vs. patients who did not receive heparin (P < .001), according to the researchers.
“By 2030, the number of arthroplasty procedures performed in the United States is expected to exceed 4 million. Given the 1%-10% incidence of PE, approximately 40,000 to 400,000 patients could be diagnosed with a PE after TJA,” the researchers wrote. “It is essential that the appropriate treatment and management of postoperative PE be defined while providing individualized care based on risk stratification.”
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.