The new LEM caval filter in the prevention of pulmonary embolism. Preliminary results of a French multicenter study

Preliminary results are reported of a prospective multicenter trial of a new caval filter (LEM*) implanted by the percutaneous jugular route in 100 patients, 55 men and 45 women, mean age 67 +/- 13 years, to produce partial interruption of inferior vena cava (IVC). Of the 100 attempts to insert the LEM* filter, 2 failures to catheterize the jugular vessel were reported, 98 filters being placed in the IVC with 82 implantation considered adequate. Of the remaining 16 cases, the filter was inclined (7 cases) or incompletely open (9 cases) with total lack of success in 3 cases. Overall efficacy was obtained therefore in 95 cases. Follow up included 94 patients seen after one week, 63 after 3 months and 10 after 6 months: 3 embolic recurrences were noted (3.2%) of cases. None of the 8 deaths reported was related to the thromboembolic disease. Standard frontal abdominal radiographic images showed migration of filter in 13 cases (13.7%) not exceeding the height of a vertebral body: 9 were caudal and 4 proximal, the LEM* filter remaining within the IVC. Phlebocavography in 90 cases showed the IVC to be permeable in 84 cases (93.3%). Incomplete opening or inclination of filter had no effect on the course. These findings demonstrate that the advantages of the LEM* filter include: a percutaneous introduction allowing rapid, certain insertion, and a form studied for limitation of inclination and avoidance of perforation of the IVC.(ABSTRACT TRUNCATED AT 250 WORDS)