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Percutaneous placement of the Greenfield vena caval filter
T J Welch1, A W Stanson, P F Sheedy
1Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905.
Insights
Percutaneous placement of Greenfield vena caval filters is a safe and effective procedure for patients unable to use anticoagulation. This study found minimal complications and no mortality in 50 patients.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- Deep venous thrombosis (DVT) and pulmonary emboli (PE) are serious conditions.
- Anticoagulation therapy is the standard treatment but carries risks.
- Patients with contraindications or complications from anticoagulation require alternative treatments.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous Greenfield vena caval filter placement.
- To assess the complication rate and patient tolerance of this procedure.
Main Methods:
- Fifty patients underwent percutaneous Greenfield vena caval filter placement between August 1986 and August 1987.
- Access was gained via the right femoral vein, left femoral vein, or right internal jugular vein.
- Procedures were performed under local anesthesia in the angiographic suite.
Main Results:
- Percutaneous placement was successful and well-tolerated in all 50 patients.
- Short-term follow-up (3 months to 1 year) revealed three complications: DVT in two patients and filter misplacement in one.
- All three patients managed these complications effectively.
Conclusions:
- Percutaneous Greenfield vena caval filter placement is a readily achievable and safe procedure.
- The technique is associated with minimal morbidity and no mortality in this patient cohort.
- This method offers a viable alternative for patients with contraindications to anticoagulation.
Abstract:
During the period from August 1986 to August 1987, 50 patients underwent percutaneous placement of a Greenfield vena caval filter from the right femoral vein, left femoral vein, or right internal jugular vein at our institution. All 50 patients had a contraindication to anticoagulation therapy or had complications of anticoagulation for deep venous thrombosis or pulmonary emboli. The percutaneous placement was accomplished in the angiographic suite with use of local anesthesia and was well tolerated by all patients. Only three complications related to the percutaneous approach occurred during the short-term follow-up (3 months to 1 year). These complications were deep venous thrombosis of the leg in two patients and misplacement of the filter in one patient. The three patients tolerated these complications well. We conclude that placement of Greenfield vena caval filters can be readily accomplished by means of percutaneous entry. Our experience demonstrated minimal associated morbidity and no mortality.