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Old 06-17-2011
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Heart LMWH or IVC filter ?

confusing when to use IVC filter


for example

if woman on heparin since two days because she have PULMONARY EMBOLISM but she now bleed from catheter site
and every where , we stop heparin , day after she develop pulmonary embolism again what should i do ?

A- IVC filter

B- LMWH

C- re-continue heparin
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Old 06-17-2011
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A ivc filter becasue there is CI to anticoagulant
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Old 06-17-2011
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PE interventions can definitely be confusing. Here are some general guidelines.

According to my question bank notes:

When presented with patient with an acute PE in whom anticoagulation is contraindicated (uncontrolled active bleeding) you must determine if the patient is hemodynamically stable or unstable.

-stable: IVC filter
-unstable: pulmonary embolectomy and IVC filter


According to UpToDate

The only widely accepted and validated indications for IVC filter placement are:

-Absolute contraindication to therapeutic anticoagulation
-Failure of anticoagulation when there is acute proximal venous thrombosis.

Other indications and uses are considered controversial.


In regards to which anticoagulant to choose: Subcutaneous low molecular weight is recommended over intravenous unfractionated heparin, SC LMWH results in lower mortality, fewer recurrent thrombotic events, and less major bleeding. (UpToDate)

I hope that helps!
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Old 08-18-2016
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Quote:
Originally Posted by kemoo View Post
confusing when to use IVC filter


for example

if woman on heparin since two days because she have PULMONARY EMBOLISM but she now bleed from catheter site
and every where , we stop heparin , day after she develop pulmonary embolism again what should i do ?

A- IVC filter

B- LMWH

C- re-continue heparin
Consult your doctor first before implanting any filter as it can cause your the serious side effects which cannot be cure easily.
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Cardiology-, Hematology-, Internal-Medicine-

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