LIMB ASYMMETRY IN TITANIUM GREENFIELD FILTERS - CLINICALLY SIGNIFICANT

Purpose: The purpose of this study was to determine the outcomes for p atients with titanium Greenfield vena caval filters (TGFs) and, in par ticular, to evaluate the effect of filter leg distribution on recurren t pulmonary embolism (PE) and caval occlusion. Methods: Physical exami nation, abdominal plain films, and duplex ultrasound examinations of t he inferior vena cava and lower extremities were obtained annually and recorded in a Filter Database. Results: Seven hundred eighty-three TG Fs have been placed since 1989. Follow-up was available for 373 patien ts, or 65% of the surviving patients, over 1 to 84 months (mean, 33 mo nths). Asymmetry was identified in 42 placements (5%), and 35 of these patients had at least one follow-up examination. The overall incidenc e of recurrent PE was 3.2% (12 of 373), whereas the caval patency rate was 97.8% (265 of 271). These outcomes were not significantly differe nt for patients who had asymmetric filters (p = 0.1 and 0.18, respecti vely). Conclusions: Filter leg distribution does not appear to be asso ciated with an increased incidence of recurrent PE or caval occlusion. These data support earlier in vitro findings. The long-term results w ith the TGF are comparable with the results of the original stainless steel Greenfield filter.