The greenfield filter: An advance in pulmonary embolism management

In the nine months from September 1st, 1982-June 30th, 1983 nine patients underwent an insertion of a Greenfield Inferior Vena Cavai filter for prevention of pulmonary embolism from deep venous thrombosis at St. Laurence's Hospital, Dublin. In these patients anticoagulant therapy had been found to be either inappropriate or ineffective. Four patients had developed recurrent pulmonary embolism while adequately anticoagulated. In the other five, anticoagulation was contra-indicated: four because of the need for an operation and one because of intracranial haemmorhage. Two of the filters were placed above the renal veins without adverse effect. No patients developed embolism subsequent to insertion of the filter. Two patients developed recurrent acute deep venous thrombosis. One patient developed a neck haematoma. The Greenfield filter appears to be a significant advance in the prevention of pulmonary embolism in a particular small group of patients. It has been safe and effective in clinical use in this small series of patients, the majority of whom were seriously ill.