title: Clinical experience with superior vena caval Greenfield filters.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Maimonides Medical Center, Brooklyn, New York 11219, USA.
authors.forename: E
authors.initials: E
authors.lastname: Ascher
authors.forename: A
authors.initials: A
authors.lastname: Hingorani
authors.forename: F
authors.initials: F
authors.lastname: Mazzariol
authors.forename: T
authors.initials: T
authors.lastname: Jacob
authors.forename: W
authors.initials: W
authors.lastname: Yorkovich
authors.forename: P
authors.initials: P
authors.lastname: Gade
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001367:Axillary Vein; D005260:Female; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D013350:Subclavian Vein; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D016306:Vena Cava Filters; D014683:Vena Cava, Superior / Q000601:surgery*; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*