Inferior vena cava ligation versus the Mobin-Uddin filter for prevention of recurrent pulmonary embolism

Sixty-nine patients (37.5%) presented recurrent pulmonary embolic phenomena. Of these, 62 patients underwent interruption of the inferior vena cava by total surgical ligature (11 patients) or partial interruption by means of a transvenous Mobin-Uddin umbrella filter (51 patients). The mortality was 0.9% in the ligature group and zero in the Mobin-Uddin filter group. Eight patients developed mild to moderate late sequelae in the inferior extremities following ligature. No sequelae were observed following the filter method. None of the patients treated by either form of inferior vena caval interruption developed evidence of recurrent pulmonary embolism. In our opinion, pulmonary perfusion isotopic scanning is the most accessible and reliable method for the diagnosis and follow-up of recurrent pulmonary embolic disease. The Mobin-Uddin inferior vena cava filter is an effective device for the control of recurrent pulmonary embolism, relatively easy to apply and highly satisfactory for the management of the seriously ill patient.