5.2 Pulmonary Embolus Post ABI

Case Study (continued)

Shortly after the surgery he developed problems with respiratory distress and was diagnosed with a right DVT as well as a suspected pulmonary embolus. 

How should a suspected pulmonary embolus and diagnosed DVT be treated in light of the patient’s epidural hematoma?

  1. Should not use anticoagulation in the acute phase.
     
  2.  Inferior vena cava filter would be indicated in this case.
  • One method of mechanical DVT prevention is the vena cava filter (pictured here) 1.
     
  • These filters, of which there are several varieties to choose from, are inserted into the inferior vena cava to prevent the passage of emboli into the lungs.  Some reports have demonstrated success rates as high as 96% in the prevention of pulmonary emboli 2.
     
  • However, the use of vena cava filters also carry some associated risks:
  • They can become blocked or dislodged, which can both increase the risk of an embolism. 
     
  • Some have also reported increased risks for repeated DVT in patients with vena cava filters compared with patients without such devices 3.

LINK IN PICTURE OF V C FILTER.

Case Study (continued)

An IVC filter was inserted for two weeks and then removed. Patient was then initiated on Coumadin.