Problems in placement of the Greenfield inferior vena cava filter

Placement of an intracaval device is the treatment of choice for failure of, or contraindication to, anticoagulation therapy. A retrospective study of 111 patients from 1980 to 1986 was undertaken to identify the incidence and degree of related complications or problems regarding placement of the device. Ninety seven of 111 (87.4%) patients had no complications or problems in placement; 14/111 (12.6%) patients did have problems. Of the latter group, mechanical problems included eccentric filter placement, insertional difficulty, problems in filter carrier removal, premature discharge, and misplacement. A total of four patients required a second filter. A single instance of worsening renal insufficiency was noted. Of the total group (ages 24 to 97 [means = 62.4] years), other medical problems including diabetes, smoking, malignancy, sepsis, hypertension, and alcoholism had no influence on the complications or problems. The Greenfield filter remains the method of choice for the listed indications; however, an awareness of potential problems may lessen the technical complications. The operative problems did not adversely impact hospital morbidity or cost.