Clinical experience with superior vena caval Greenfield filters

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Cardiology

Background:

• Upper extremity deep venous thrombosis (UEDVT) poses a risk of pulmonary embolism (PE).
• Anticoagulation therapy is not always suitable or effective for preventing PE in UEDVT patients.
• Inferior vena cava filters are established for PE prevention, but superior vena cava (SVC) filters are less commonly studied for upper extremity thrombi.

Purpose of the Study:

• To assess the efficacy and safety of Greenfield filters placed in the superior vena cava (SVC) for preventing PE in patients with UEDVT.
• To evaluate filter placement, migration, and clinical outcomes in this patient population.

Main Methods:

• A retrospective study of 26 patients with UEDVT who underwent SVC Greenfield filter placement over 46 months.
• Patients included those with contraindications to anticoagulation or ineffective anticoagulation therapy.
• Follow-up included clinical assessment and sequential chest roentgenograms.

Main Results:

• One filter was misplaced but remained patent without migration.
• No filter migration or displacement was observed in 82% of patients with sequential roentgenograms.
• No recurrent PE was detected in survivors during the follow-up period.
• In-hospital mortality was 58%, unrelated to the filter or recurrent thromboembolism.

Conclusions:

• Superior vena cava (SVC) Greenfield filter insertion is a safe and feasible treatment option.
• Filters effectively prevent recurrent thromboembolism in UEDVT patients unsuitable for anticoagulation.
• This intervention offers a viable alternative for managing PE risk in specific UEDVT cases.