REGULAR CONTENT
Final ID
566
Type
Original Scientific Research-Oral or Pos
Authors
B Sur1, D Maldow2, D Lee1, V Khanna1, D Butani2
Institutions
1University of Rochester Medical Center, Rochester, NY, 2N/A, Rochester, NY
Purpose
To evaluate safety, efficacy, and potential complication of IVC filter placement in patients with bacteremia or sepsis with unknown source of infection.
Materials & Methods
We performed a retrospective review of patients who underwent IVC filter placement between January 2011 and August 2016 to identify patients who had a positive blood culture result within 72 hours prior to the procedure or whose IVC filter was placed when they met two or more of SIRS criteria with unknown source of infection. Clinical notes and relevant imaging studies were analyzed to identify patients who developed new or recurrent pulmonary embolism (PE), IVC thrombosis, or required prolonged course of antibiotic treatment determined by the patient's primary team.
Results
We identified 20 patients who underwent IVC filter placement with a positive blood culture result within 72 hours prior to the procedure (10 patients within 24 hours, 3 patients within 48 hours, and 7 patients within 72 hours). 16/20 patients (80%) met two or more of the SIRS criteria on the day of IVC filter placement. 15/20 patients (75%) with bacteremia had been on antibiotics prior to the IVC placement. No patient received additional peri- or intra-procedural antibiotics. Except two patients diagnosed with endocarditis before IVC filter placement, none required prolonged antibiotics treatment. No patient developed new or recurrent PE or IVC thrombosis. In addition, 14 patients had their IVC filter placed when they met two or more of the SIRS criteria with clinically unknown source of infection. None of the patients developed new or recurrent PE or IVC thrombosis or required prolonged antibiotic treatment after IVC filter placement.
Conclusions
Active bacteremia or sepsis with unknown source of infection should be considered a relative contraindication, especially in cases with life-threatening acute PE with right heart strain or large ilio-femoral clot burden. The benefit of a life saving intervention should be balanced against the risk for seeding. Permanent caval filtration is no longer the only available choice and a retrievable filter can be safely removed within 1-2 months.
Final ID
566
Type
Original Scientific Research-Oral or Pos
Authors
B Sur1, D Maldow2, D Lee1, V Khanna1, D Butani2
Institutions
1University of Rochester Medical Center, Rochester, NY, 2N/A, Rochester, NY
Purpose
To evaluate safety, efficacy, and potential complication of IVC filter placement in patients with bacteremia or sepsis with unknown source of infection.
Materials & Methods
We performed a retrospective review of patients who underwent IVC filter placement between January 2011 and August 2016 to identify patients who had a positive blood culture result within 72 hours prior to the procedure or whose IVC filter was placed when they met two or more of SIRS criteria with unknown source of infection. Clinical notes and relevant imaging studies were analyzed to identify patients who developed new or recurrent pulmonary embolism (PE), IVC thrombosis, or required prolonged course of antibiotic treatment determined by the patient's primary team.
Results
We identified 20 patients who underwent IVC filter placement with a positive blood culture result within 72 hours prior to the procedure (10 patients within 24 hours, 3 patients within 48 hours, and 7 patients within 72 hours). 16/20 patients (80%) met two or more of the SIRS criteria on the day of IVC filter placement. 15/20 patients (75%) with bacteremia had been on antibiotics prior to the IVC placement. No patient received additional peri- or intra-procedural antibiotics. Except two patients diagnosed with endocarditis before IVC filter placement, none required prolonged antibiotics treatment. No patient developed new or recurrent PE or IVC thrombosis. In addition, 14 patients had their IVC filter placed when they met two or more of the SIRS criteria with clinically unknown source of infection. None of the patients developed new or recurrent PE or IVC thrombosis or required prolonged antibiotic treatment after IVC filter placement.
Conclusions
Active bacteremia or sepsis with unknown source of infection should be considered a relative contraindication, especially in cases with life-threatening acute PE with right heart strain or large ilio-femoral clot burden. The benefit of a life saving intervention should be balanced against the risk for seeding. Permanent caval filtration is no longer the only available choice and a retrievable filter can be safely removed within 1-2 months.