Clinical Presentation of Thrombosed Greenfield Filters

Abstract

The tour de force of this paper lies in the review of clinical presentation of occluded Greenfield filters in a group of patients contraindicated for postopera tive anticoagulation. Nine of 59 patients (15.3%) had occluded filters. Eight of these 9 patients (88.8%) had primary brain tumors. This study, for the first time, to the authors' knowledge, reports a high incidence of caval thrombosis in brain tumor patients (8/31:25.8%) and of an association between caval throm bosis and recurrent deep vein thrombosis. Deep vein thrombosis (DVT) was seen in 88.8% of patients with caval thrombosis in this service. It is the authors' contention that recurrent DVT, at least in brain tumor patients, should alert the physician to evaluate caval patency. Caval thrombosis was noticed even sixty weeks after the placement of Greenfield filter. The authors conclude, therefore, that brain tumor patients had a high incidence of occluded filters; lower extrem ity morbidity provided a clue to such an event, and such a scenario should raise concerns regarding caval patency, even in long-term follow-up.