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Purpose: To report a 10-year clinical experience with superior vena cava (SVC) retrievable filters., Methods: A retrospective review of patients with SVC filters was performed between 2008 and 2018 in a single tertiary medical center. Patient demographics, indications for filter placement, type of filter placed, and clinical evolution were recorded. Complications during placement, retrieval, and follow-up were determined., Results: Fifty patients ages 17-89 years (average 54) underwent SVC retrievable filter placement. Main indication for filter placement was deep venous thrombosis of the major upper extremity and/or internal jugular veins with contraindications to anticoagulation. Complications during placement included inadvertent filter placement in the right brachiocephalic vein in two patients, another patient had a leg of the filter entrapped in the tip of a hemodialysis catheter that required filter reposition and line exchange. Thirteen patients had attempted retrieval with 12 filters successfully removed 7-420 days after placement (mean 170). On follow-up images available in 24 patients, 13 filters were noted to be significantly tilted and 10 filters had evidence of leg penetration. No other serious late complications were noted., Conclusion: The use of retrievable SVC filters in patients with upper extremity DVT is highly questionable. There is a high incidence of filter malposition, filter tilting, and leg penetration., (© 2019 Wiley Periodicals, Inc.)

The association between help-seeking and nearly lethal suicide attempts was evaluated using data from a population-based, case-control study of 153 13- to 34-year-old suicide attempt case-patients treated at emergency departments in Houston, Texas, and a random sample of 513 control-subjects. Measures of help-seeking included whether the participant sought help for health/emotional problems in the past month, type of consultant contacted, and whether suicide was discussed during the interaction. Overall, friends/family were consulted most frequently (48%). After controlling for potential confounders, case-patients were less likely than control-subjects to seek help from any consultant (OR = 0.5, 95% CI = 0.3-0.8) or a professional (e.g., physician, counselor) consultant (OR = 0.5, 95%CI = 0.29-0.8). Among those who sought help, case-patients were more likely than to discuss suicide (OR = 2.6, 95% CI = 1.2-5.4), particularly with professionals (OR = 11.8, 95% CI = 3.2-43.2). Our findings suggest that efforts to better understand the role of help-seeking in suicide prevention, including help sought from family and friends, deserves further attention.