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Recurrent pulmonary embolism after Greenfield filter placement.
M A Geisinger1, M G Zelch, B Risius
1Department of Diagnostic Radiology, Cleveland Clinic Foundation, OH 44106.
Radiology
|November 1, 1987
Summary
Recurrent pulmonary embolism despite inferior vena cava (IVC) filters can occur due to thrombus passing through struts, IVC occlusion at the filter, or filter detachment. These findings highlight potential failure modes of IVC filters in preventing embolism.
Area of Science:
- Vascular surgery
- Interventional radiology
- Cardiology
Background:
- Inferior vena cava (IVC) filters are used to prevent pulmonary embolism.
- Recurrent pulmonary embolism (PE) can occur even with an IVC filter in place.
Observation:
- Contrast-enhanced cavography was performed on three patients with recurrent PE and existing IVC Greenfield filters.
Findings:
- Thrombus propagation through filter struts was observed.
- Occlusion of the IVC at the filter level was identified.
- Loss of filter hook contact with the caval wall was noted.
Implications:
- Understanding these failure mechanisms is crucial for managing patients with recurrent PE and IVC filters.
- Cavography can elucidate the reasons for filter failure.
- Further research into IVC filter design and patient selection may be warranted.