Prophylactic placement of vena caval filters

A cautionary note

Barry S. Greene, Gregory Hellwarth, William K. Rundell, Gary Lemmon, C. Daniel Procter

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Greenfield filter placement in patients without deep venous thrombosis has been performed when such patients were felt to be at high risk for asymptomatic deep venous thrombosis and subsequent embolus. In this group placement is termed "truly prophylactic" to differentiate from placement in a patient with documented deep venous thrombosis which has not yet embolized. A retrospective review of Greenfield filter placement at five Dayton, Ohio, community hospitals over three years revealed 59 filters placed in 58 patients. Of these 90% were placed surgically and 10% percutaneously at an average cost of $4,141.00 per surgical procedure. Indications included traditional as well as true prophylaxis. A low morbidity and no mortality related to filter placement was observed. The high efficacy and safety of filter placement seen at large institutions is also found in our community hospital experience despite placement by physicians who perform the procedure infrequently. Although filter placement in patients at a high risk for silent fatal pulmonary emboli may prevent a rare mortality, widespread use of this modality for pulmonary embolus prophylaxis is costly and not without patient risk. We caution against the use of Greenfield filters for pulmonary embolus prophylaxis in patients without deep venous thrombosis until evidence of superior efficacy compared to other forms of prophylaxis can be demonstrated.

Original languageEnglish (US)
Pages (from-to)229-232
Number of pages4
JournalAnnals of Vascular Surgery
Volume4
Issue number3
DOIs
StatePublished - May 1990
Externally publishedYes

Fingerprint

Venae Cavae
Embolism
Venous Thrombosis
Community Hospital
Lung
Mortality
Morbidity
Physicians
Safety
Costs and Cost Analysis

Keywords

  • Deep venous thrombosis
  • Greenfield vena caval filter
  • pulmonary embolus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Greene, B. S., Hellwarth, G., Rundell, W. K., Lemmon, G., & Procter, C. D. (1990). Prophylactic placement of vena caval filters: A cautionary note. Annals of Vascular Surgery, 4(3), 229-232. https://doi.org/10.1007/BF02009449

Prophylactic placement of vena caval filters : A cautionary note. / Greene, Barry S.; Hellwarth, Gregory; Rundell, William K.; Lemmon, Gary; Procter, C. Daniel.

In: Annals of Vascular Surgery, Vol. 4, No. 3, 05.1990, p. 229-232.

Research output: Contribution to journalArticle

Greene, BS, Hellwarth, G, Rundell, WK, Lemmon, G & Procter, CD 1990, 'Prophylactic placement of vena caval filters: A cautionary note', Annals of Vascular Surgery, vol. 4, no. 3, pp. 229-232. https://doi.org/10.1007/BF02009449
Greene, Barry S. ; Hellwarth, Gregory ; Rundell, William K. ; Lemmon, Gary ; Procter, C. Daniel. / Prophylactic placement of vena caval filters : A cautionary note. In: Annals of Vascular Surgery. 1990 ; Vol. 4, No. 3. pp. 229-232.
@article{bf44af830d054a349e5a272fd7227bac,
title = "Prophylactic placement of vena caval filters: A cautionary note",
abstract = "Greenfield filter placement in patients without deep venous thrombosis has been performed when such patients were felt to be at high risk for asymptomatic deep venous thrombosis and subsequent embolus. In this group placement is termed {"}truly prophylactic{"} to differentiate from placement in a patient with documented deep venous thrombosis which has not yet embolized. A retrospective review of Greenfield filter placement at five Dayton, Ohio, community hospitals over three years revealed 59 filters placed in 58 patients. Of these 90{\%} were placed surgically and 10{\%} percutaneously at an average cost of $4,141.00 per surgical procedure. Indications included traditional as well as true prophylaxis. A low morbidity and no mortality related to filter placement was observed. The high efficacy and safety of filter placement seen at large institutions is also found in our community hospital experience despite placement by physicians who perform the procedure infrequently. Although filter placement in patients at a high risk for silent fatal pulmonary emboli may prevent a rare mortality, widespread use of this modality for pulmonary embolus prophylaxis is costly and not without patient risk. We caution against the use of Greenfield filters for pulmonary embolus prophylaxis in patients without deep venous thrombosis until evidence of superior efficacy compared to other forms of prophylaxis can be demonstrated.",
keywords = "Deep venous thrombosis, Greenfield vena caval filter, pulmonary embolus",
author = "Greene, {Barry S.} and Gregory Hellwarth and Rundell, {William K.} and Gary Lemmon and Procter, {C. Daniel}",
year = "1990",
month = "5",
doi = "10.1007/BF02009449",
language = "English (US)",
volume = "4",
pages = "229--232",
journal = "Annals of Vascular Surgery",
issn = "0890-5096",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Prophylactic placement of vena caval filters

T2 - A cautionary note

AU - Greene, Barry S.

AU - Hellwarth, Gregory

AU - Rundell, William K.

AU - Lemmon, Gary

AU - Procter, C. Daniel

PY - 1990/5

Y1 - 1990/5

N2 - Greenfield filter placement in patients without deep venous thrombosis has been performed when such patients were felt to be at high risk for asymptomatic deep venous thrombosis and subsequent embolus. In this group placement is termed "truly prophylactic" to differentiate from placement in a patient with documented deep venous thrombosis which has not yet embolized. A retrospective review of Greenfield filter placement at five Dayton, Ohio, community hospitals over three years revealed 59 filters placed in 58 patients. Of these 90% were placed surgically and 10% percutaneously at an average cost of $4,141.00 per surgical procedure. Indications included traditional as well as true prophylaxis. A low morbidity and no mortality related to filter placement was observed. The high efficacy and safety of filter placement seen at large institutions is also found in our community hospital experience despite placement by physicians who perform the procedure infrequently. Although filter placement in patients at a high risk for silent fatal pulmonary emboli may prevent a rare mortality, widespread use of this modality for pulmonary embolus prophylaxis is costly and not without patient risk. We caution against the use of Greenfield filters for pulmonary embolus prophylaxis in patients without deep venous thrombosis until evidence of superior efficacy compared to other forms of prophylaxis can be demonstrated.

AB - Greenfield filter placement in patients without deep venous thrombosis has been performed when such patients were felt to be at high risk for asymptomatic deep venous thrombosis and subsequent embolus. In this group placement is termed "truly prophylactic" to differentiate from placement in a patient with documented deep venous thrombosis which has not yet embolized. A retrospective review of Greenfield filter placement at five Dayton, Ohio, community hospitals over three years revealed 59 filters placed in 58 patients. Of these 90% were placed surgically and 10% percutaneously at an average cost of $4,141.00 per surgical procedure. Indications included traditional as well as true prophylaxis. A low morbidity and no mortality related to filter placement was observed. The high efficacy and safety of filter placement seen at large institutions is also found in our community hospital experience despite placement by physicians who perform the procedure infrequently. Although filter placement in patients at a high risk for silent fatal pulmonary emboli may prevent a rare mortality, widespread use of this modality for pulmonary embolus prophylaxis is costly and not without patient risk. We caution against the use of Greenfield filters for pulmonary embolus prophylaxis in patients without deep venous thrombosis until evidence of superior efficacy compared to other forms of prophylaxis can be demonstrated.

KW - Deep venous thrombosis

KW - Greenfield vena caval filter

KW - pulmonary embolus

UR - http://www.scopus.com/inward/record.url?scp=0025073628&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025073628&partnerID=8YFLogxK

U2 - 10.1007/BF02009449

DO - 10.1007/BF02009449

M3 - Article

VL - 4

SP - 229

EP - 232

JO - Annals of Vascular Surgery

JF - Annals of Vascular Surgery

SN - 0890-5096

IS - 3

ER -