Related Experiment Video
Updated: Aug 2, 2026
07:59
Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
Published on: July 28, 2018
[Pulmonary embolism despite inferior vena cava filter]
O Gofrit1, A Pikarsky, I Perry
1General Surgery Dept., Hadassah-University Hospital, Jerusalem.
Harefuah
|February 1, 1994
Summary
The Greenfield filter prevents pulmonary embolism in high-risk patients but isn't foolproof. This case shows pulmonary embolism can still occur even after filter placement.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Oncology
Background:
- Inferior Vena Cava (IVC) filters, like the Greenfield filter, are used to prevent pulmonary embolism (PE) in high-risk patients.
- Despite their effectiveness, IVC filters do not offer absolute protection against PE.
Observation:
- A 69-year-old male with deep vein thrombosis (DVT) and an incidentally discovered pancreatic tumor (Trousseau's sign) underwent Greenfield filter placement.
- The patient developed clinical signs of PE 11 days post-total pancreatectomy, confirmed by ventilation-perfusion scan.
Findings:
- The incidence of PE after IVC interruption with a Greenfield filter is low (2.2%).
- This case highlights a rare instance of PE occurring despite IVC filter placement.
Implications:
- Pulmonary embolism must be considered in patients presenting with relevant clinical signs, irrespective of IVC filter status.
- Vigilance for PE is crucial in high-risk surgical patients, even those protected by IVC filters.
Related Concept Videos
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:29Pulmonary Embolism I: Introduction
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:27Pulmonary Embolism III: Nursing Management
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
01:19Pulmonary Embolism I: Introduction
A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...