Inferior vena caval filters following deep vein thrombosis in patients with ruptured intracranial aneurysm

KC Wong, R Boet, WS Poon, S Yu
Division of Neurosurgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

Anticoagulant therapy is highly effective and prevents death in more than 95% of patients who have suffered pulmonary embolism following deep vein thrombosis. Inferior vena caval filters provide an alternative to full anti-coagulation in those patients at highest risk of catastrophic haemorrhagic complications. We report on two patients who developed deep vein thrombosis following ruptured unsecured intracranial aneurysms. Inferior vena caval filters were inserted prior to aneurysm clipping, as a prophylactic measure to prevent pulmonary embolism while awaiting surgery. The patients did not receive anticoagulant therapy following successful clipping of the aneurysm. Both patients had clinical resolution of the lower limb swelling and no radiological evidence of propagation of the thrombus. During 18 months of follow-up there were no complications and no evidence of post-thrombotic syndrome.

Hong Kong Med J 2002;8:288-90

Key words: Intracranial aneurysm; Vena cava filters; Venous thrombosis