Clinical experience with superior vena caval Greenfield filters

To evaluate the results of superior vena caval (SVC) Greenfield filters in patients at risk for pulmonary embolism (PE) secondary to upper extremity deep venous thrombosis (UEDVT). Over a 46-month period, 26 patients (10 men, mean age 67 years, range 25 to 89) with UEDVT in whom anticoagulation was...

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Bibliographic Details
Published in:Journal of endovascular surgery 1999-11, Vol.6 (4), p.365-369
Main Authors: Ascher, E, Hingorani, A, Mazzariol, F, Jacob, T, Yorkovich, W, Gade, P
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Axillary Vein
Female
Humans
Jugular Veins
Male
Middle Aged
Phlebography
Pulmonary Embolism - diagnostic imaging
Pulmonary Embolism - etiology
Pulmonary Embolism - prevention & control
Retrospective Studies
Subclavian Vein
Treatment Outcome
Ultrasonography, Doppler, Duplex
Vena Cava Filters
Vena Cava, Superior - surgery
Venous Thrombosis - complications
Venous Thrombosis - diagnosis
Venous Thrombosis - diagnostic imaging
Venous Thrombosis - therapy
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Summary:To evaluate the results of superior vena caval (SVC) Greenfield filters in patients at risk for pulmonary embolism (PE) secondary to upper extremity deep venous thrombosis (UEDVT). Over a 46-month period, 26 patients (10 men, mean age 67 years, range 25 to 89) with UEDVT in whom anticoagulation was contraindicated (n = 22) or ineffective in preventing recurrent PE or extension of the thrombus (n = 4) were treated with placement of SVC Greenfield filters. One SVC filter was misplaced into the innominate vein but left in place; this vein remains patent after 2 months without evidence of filter migration. Follow-up ranged from 10 days to 46 months (mean 7.8 months). Fifteen (58%) patients died inhospital of causes unrelated to the SVC filter or recurrent thromboembolism (mean time to death 36 days). Of the 11 survivors, follow-up ranged from 1 to 38 months (mean 22). Sequential chest roentgenograms in 9 (82%) patients revealed no filter migration or displacement. No evidence of PE was found in any of the survivors over the course of follow-up. Insertion of SVC Greenfield filters is a safe and feasible therapy to prevent recurrent thromboembolism in patients with UEDVT who are refractory to or inappropriate for anticoagulation therapy.
ISSN:1074-6218
DOI:10.1583/1074-6218(1999)006<0365:CEWSVC>2.0.CO;2