A prospective observational study of IVC filters in pediatric patients.

BACKGROUND: The use of inferior vena cava (IVC) filters to prevent pulmonary embolism (PE) has increased with the advent of retrievable filters (Crowther: Am J Med 120: S13-S17, 2007). Both permanent and retrievable filters have been used in the pediatric population, though reports describing such patients and their outcomes are limited.

PROCEDURE: Our center has established a longitudinal prospective cohort study of consecutive patients with acute venous thromboembolism (VTE) at our pediatric tertiary care institution. Data collection in this study includes medical history, risk factors, radiologic and laboratory studies, therapy, and follow-up.

RESULTS: Two hundred ten patients were enrolled into this cohort from January 2003 to January 2007. IVC filters were percutaneously placed into 11 patients, ranging in age from 6.8 to 23.4 years. The primary reason for filter placement was a VTE and a contraindication to anticoagulation. Nine patients had retrievable filters placed and two received permanent filters. Seven of the nine retrievable filters were removed 21-97 days (median 37 days) after placement. In the remaining two patients, thrombus prevented removal in one, and the filter was electively retained in the other. One patient with a permanent filter died from malignancy. The three patients who are alive and well with IVC filters have had them for 25-60 months. No patient with an IVC filter developed a subsequent PE.

CONCLUSIONS: Approximately 5% of patients in this pediatric thrombosis cohort received an IVC filter. The placement and removal of these devices is technically feasible in children.