Preliminary clinical experience with the titanium Greenfield vena caval filter
L. J. Greenfield, K. J. Cho, S. O. Pais and M. Van Aman
Department of Surgery, University of Michigan Medical Center, Ann Arbor.
Preliminary clinical experience in 40 patients from three institutions is
reported for a new titanium model of the Greenfield vena caval filter. The
titanium filter is slightly larger than the standard stainless steel filter
and can be loaded into a 12 F diameter carrier system as opposed to the 24
F stainless steel filter. In patients ranging from 17 to 94 years of age,
percutaneous insertions were made from the right femoral vein in 24
patients, the left femoral vein in 11 patients, and the right internal
jugular in 2 patients. Operative access was obtained in 1 patient each from
the right femoral, right jugular, and a lumbar vein at laparotomy.
Insertion was completed in all cases but 1 and only 1 patient (3%) showed
postoperative femoral vein thrombosis. Distal filter migration was seen in
3 cases (7.5%) without sequelae, and there was no proximal migration. The
titanium Greenfield vena caval filter provides improved ease of insertion,
and the sheath technique should prevent misplacement. Distal migration
should be preventable by techniques to promote hook engagement at the time
of insertion.
