Recurrent pulmonary embolism after inferior vena caval interruption with a Greenfield filter.
Twenty-six patients have undergone inferior vena caval interruption with a Greenfield filter. One patient (3.8%) developed a fatal, recurrent pulmonary embolism. Postmortem examination documented the presence of thrombus within the filter, proximal extension of thrombus beyond the filter apex, and fresh pulmonary emboli. In a combined series of 556 patients, 12 patients (2.2%) developed recurrent pulmonary emboli, 2 (0.36%) of which were fatal. Including case reports, 18 patients have had documented recurrent pulmonary emboli following Greenfield filter insertion. In 4 patients, the recurrent embolism was fatal. Six (60%) of 10 patients had a concomitant malignancy. A work-up and treatment plan for patients having recurrent pulmonary emboli after the insertion of a Greenfield vena caval filter is proposed.
Richenbacher
W E
WE
Atnip
R G
RG
Campbell
D B
DB
Waldhausen
J A
JA
D006440:Hemofiltration / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology* / Q000401:mortality; D014682:Vena Cava, Inferior / Q000601:surgery*