[A case of Günther vena caval filter insertion for recurrent pulmonary embolism]

We report that the Günther vena caval filter was successfully inserted in a case of recurrent pulmonary embolism resulting from ilio-femoral venous thrombosis. A 42-year-old woman was admitted to Osaka City University Medical School Hospital for dyspnea and chest pain on April 19, 1988. Pulmonary perfusion scintigraphy and pulmonary arterial angiography proved pulmonary emboli. The combination therapy of heparin and urokinase was performed, and her condition markedly improved. Then an ilio-femoral venography revealed only iliac vein compression but no thrombi. Therefore she was followed as an out patient with anticoagulant therapy. Nevertheless on April 10, 1989 she was admitted again complaining dyspnea and cyanosis. By venography at this time, some filling defects due to thrombi in right iliac vein were found. Therefore, we decided the insertion of the Günther vena caval filter for recurrent pulmonary embolism using Seldinger method via right internal jugular vein. We expect that the Günther vena caval filter will be useful for preventing pulmonary embolism resulting from ilio-femoral venous thrombosis because its procedure is easy, non-invasive and without significant complications.