Intracardiac and intrapulmonary Greenfield filters: a long-term follow-up

The Greenfield vena caval filter has become the preferred method of vena caval filtration. Its high long-term patency rate and low complication rate make it ideal for those patients in whom anticoagulation has failed or is contraindicated. A known complication of filter insertion is the inadvertent placement or migration of the filter to the right side of the heart. We present three cases from our institution where the Greenfield filter was inadvertently ejected into the right atrium. An attempt at removal with a wire loop and sheath in two cases failed and resulted in the migration of one filter to the right inferior pulmonary artery. We found no evidence of long-term complications at 2, 45, and 60 months. We conclude that conservative management may be considered in these cases.