Abstract
During a 5-year period, 1982–1986 inclusive, 30 patients were referred for Greenfield filter placement. The indications for filter insertion were: (1) contraindications to anticoagulation (13 patients), (2) recurrent pulmonary emboli in the presence of adequate anticoagulation (14 patients), (3) complications of anticoagulant therapy (three patients).
The contraindications to anticoagulants included subarachnoid haemorrhage, duodenal ulcer, multiple trauma and afibrinogenaemia and a group of patients in whom standard methods of prophylaxis were unsuitable.
The jugular or femoral approach was used for filter placement and in two technical failures a De Weese clip was applied. One patient died from a myocardial infarction within 3 days of filter placement and the six other deaths were due to underlying malignant disease. A follow-up ultrasound study of the inferior vena cava (IVC) among 19 of 21 survivors demonstrated patency in 14, thrombus in the filter in two and an occluded IVC in two.
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