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. 1977 Oct;186(4):491–499. doi: 10.1097/00000658-197710000-00011

Permanent transvenous balloon occlusion of the inferior vena cava: experience with 60 patients.

J A Hunter, W S Dye, H Javid, H Najafi, M D Goldin, C Serry
PMCID: PMC1396284  PMID: 907394

Abstract

Traditional operations to obstruct the IVC are often unsatisfactory because the morbidity and mortality is appreciable: poor risk patients do not tolerate surgical and anesthetic trauma. Furthermore, if the patient is anticoagulated, an operation requires that such desirable treatment be stopped. Ten years ago a study was begun to develop a transvenous method of IVC occlusion in the awake anticoagulated patient. Animal studies were done prior to patient application. A technique was evolved wherein IVC interruption could be accomplished with a balloon bearing catheter inserted through the jugular vein. The balloon was positioned with venography and after inflation held in place by lateral pressure in the distensible IVC. The catheter was then removed, leaving the balloon in position. Balloon occlusion has been used in the management of 60 selected patients since 1970. Twenty-nine patients were simultaneously anticoagulated without complication. Very sick patients tolerated the procedure well. No patient experienced further pulmonary emboli. Nine hospital deaths occurred from a variety of causes, none related to the balloon catheter. Late follow-up shows that the occluding balloon gradually deflates in about 12 months. The remnant has remained stable in all patients, contained in a scar that permanently interrupts the IVC.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beller B. M., Talley R. C., Lawrence J. L. Nonsurgical inferior vena cava obstruction for prevention of pulmonary emboli. JAMA. 1972 May 15;220(7):973–979. [PubMed] [Google Scholar]
  2. Bloomfield D. A., Jomain S. L., Cerruti M. M. Intracaval umbrella filter therapy for pulmonary embolus. Long-term results. N Y State J Med. 1975 Oct;75(12):2185–2190. [PubMed] [Google Scholar]
  3. Crane C. The Mobin-Uddin inferior vena caval filter. Arch Surg. 1971 Dec;103(6):661–661. doi: 10.1001/archsurg.1971.01350120021001. [DOI] [PubMed] [Google Scholar]
  4. Eichelter P., Schenk W. G., Jr Prophylaxis of pulmonary embolism. A new experimental appraoch with initial results. Arch Surg. 1968 Aug;97(2):348–356. doi: 10.1001/archsurg.1968.01340020212026. [DOI] [PubMed] [Google Scholar]
  5. Friedman S. A., Cerruti M. M., Berger N., Washor H., Kosmoski J. Thromboembolism with the intracaval umbrella. Am Heart J. 1972 Oct;84(4):537–539. doi: 10.1016/0002-8703(72)90478-4. [DOI] [PubMed] [Google Scholar]
  6. Fullen W. D., McDonough J. J., Altemeier W. A. Clinical experience with vena caval filters. Arch Surg. 1973 Apr;106(4):582–587. doi: 10.1001/archsurg.1973.01350160194034. [DOI] [PubMed] [Google Scholar]
  7. Genton E., Hirsh J. Observations in anticoagulant and thrombolytic therapy in pulmonary embolism. Prog Cardiovasc Dis. 1975 Mar-Apr;17(5):335–343. doi: 10.1016/s0033-0620(75)80010-7. [DOI] [PubMed] [Google Scholar]
  8. Greenfield L. J., McCurdy J. R., Brown P. P., Elkins R. C. A new intracaval filter permitting continued flow and resolution of emboli. Surgery. 1973 Apr;73(4):599–606. [PubMed] [Google Scholar]
  9. Harjola P. T., Höckerstedt K., Scheinin T. M., Standertskjöld-Nordenstam C. G., Tähti E. Vena cava umbrella filter: experimental, hemodynamic and embolization studies. J Cardiovasc Surg (Torino) 1975 Nov-Dec;16(6):626–631. [PubMed] [Google Scholar]
  10. Hodin E., Dass T. Spontaneous retroperitoneal hemorrhage complicating anticoagulant therapy. Ann Surg. 1969 Nov;170(5):848–851. doi: 10.1097/00000658-196911000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hunter J. A., Sessions R., Buenger R. Experimental balloon obstruction of the inferior vena cava. Ann Surg. 1970 Feb;171(2):315–320. doi: 10.1097/00000658-197002000-00023. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hunter J. A., Sessions R., Petasnick J. Therapeutic balloon occlusion of the inferior vena cava. JAMA. 1975 Dec 8;234(10):1034–1037. [PubMed] [Google Scholar]
  13. Hunter J. A. Surgery of venous and thromboembolic disease. Surg Clin North Am. 1971 Feb;51(1):99–110. doi: 10.1016/s0039-6109(16)39334-3. [DOI] [PubMed] [Google Scholar]
  14. Irvin G. L., 3rd Duodenal perforation with a vena caval umbrella. Am Surg. 1972 Nov;38(11):635–637. [PubMed] [Google Scholar]
  15. Lawrence G. H., Beebe H. G. An evaluation of the Mobin-Uddin umbrella in the prevention of pulmonary thromboembolism. Am J Surg. 1976 Aug;132(2):204–208. doi: 10.1016/0002-9610(76)90048-9. [DOI] [PubMed] [Google Scholar]
  16. Lewis M. R., Kamat P. V., Dale W. A. Balloon blockade of the inferior vena cava. Arch Surg. 1971 Mar;102(3):209–210. doi: 10.1001/archsurg.1971.01350030047012. [DOI] [PubMed] [Google Scholar]
  17. McConnell D., Mulder D., Buckberg G. The placement of vena cava umbrella filters. The value of phlebography. Arch Surg. 1974 Jun;108(6):789–791. doi: 10.1001/archsurg.1974.01350300031008. [DOI] [PubMed] [Google Scholar]
  18. Meier M. A., Burman S. O., Hastreiter A. R., Long D. M. Interruption of double inferior vena cava for prevention of pulmonary embolism. Ann Surg. 1972 Dec;176(6):769–771. doi: 10.1097/00000658-197212000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Mobin-Uddin K., Callard G. M., Bolooki H., Rubinson R., Michie D., Jude J. R. Transvenous caval interruption with umbrella filter. N Engl J Med. 1972 Jan 13;286(2):55–58. doi: 10.1056/NEJM197201132860202. [DOI] [PubMed] [Google Scholar]
  20. Mobin-Uddin K., McLean R., Bolooki H., Jude J. R. Caval interruption for prevention of pulmonary embolism. Long-term results of a new method. Arch Surg. 1969 Dec;99(6):711–715. doi: 10.1001/archsurg.1969.01340180035006. [DOI] [PubMed] [Google Scholar]
  21. Mobin-Uddin K., McLean R., Jude J. R. A new catheter technique of interruption of inferior vena cava for prevention of pulmonary embolism. Am Surg. 1969 Dec;35(12):889–894. [PubMed] [Google Scholar]
  22. Mobin-Uddin K., Trinkle J. K., Bryant L. R. Present status of the inferior vena cava umbrella filter. Surgery. 1971 Dec;70(6):914–919. [PubMed] [Google Scholar]
  23. Moser K. M., Harsany P. G., Harvey-Smith W., Durante P. L., Guisan M. Reversible interruption of inferior vena cava by means of a balloon catheter. Preliminary report. J Thorac Cardiovasc Surg. 1971 Aug;62(2):205–212. [PubMed] [Google Scholar]
  24. Nevin W. S., Beddingfield G. W. Migration of vena cava filter. JAMA. 1972 Oct 2;222(1):88–88. doi: 10.1001/jama.222.1.88b. [DOI] [PubMed] [Google Scholar]
  25. Pate J. W., Melvin D., Cheek R. C. A new form of vena caval interruption. Ann Surg. 1969 Jun;169(6):873–880. doi: 10.1097/00000658-196906000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Praiss D. E., Marmar J. L., Moran J. J., Brocks E. R., Mobin-Uddin K. Is the umbrella filter safe? N Engl J Med. 1972 May 4;286(18):1006–1007. doi: 10.1056/NEJM197205042861819. [DOI] [PubMed] [Google Scholar]
  27. Ring S. M., Beranbaum E. R., Nicolosi C. R. A complication following placement of an intracaval umbrella prosthesis. J Cardiovasc Surg (Torino) 1973 Jul-Aug;14(4):460–461. [PubMed] [Google Scholar]
  28. Schlosser V., Spillner G., Kaiser W. Prevention of pulmonary embolism by inferior vena cava filters: results in 62 cases. World J Surg. 1977 Jan;1(1):113–116. doi: 10.1007/BF01654747. [DOI] [PubMed] [Google Scholar]
  29. Vieweg W. V., Piscatelli R. L., Houser J. J., Proulx R. A. Complications of intravenous administration of heparin in elderly women. JAMA. 1970 Aug 24;213(8):1303–1306. [PubMed] [Google Scholar]

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