An unusual thromboembolic complication of a Greenfield vena caval filter

The Greenfield inferior vena caval filter is highly effective in preventing recurrent pulmonary embolism and is associated with a low incidence of complications. We have recently seen a patient with the unusual finding of recurrent pulmonary embolism due to extension of thrombus from the surface of a Greenfield filter. The proximal extension of thrombus from a partially obstructed filter is documented by venacavogram. The proposed mechanism is discussed and principles of management are reviewed.