ABSTRACT
We have treated 34 patients with the Günther filter. Follow-up ranged from 5 to 891 days (median 129). Eight patients died 5-352 days (median 26) after filter insertion, without relation to the procedure. Six of them had extensive cancer. At 2 weeks, a mean caudal migration of 27 +/- 20 mm of the Günther filter was observed (n = 24). No significant migration occurred later than 2 weeks. In 2 patients, downward displacement of the device to the iliocaval junction was observed, with recurrent embolism in 1 case. A second filter was placed in the infrarenal vena cava in both cases. There was no other recurrent embolism and no sign of vena caval occlusion.
Subject(s)
Vena Cava Filters , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Foreign-Body Migration , Humans , Male , Middle Aged , Pulmonary Embolism/prevention & control , RecurrenceABSTRACT
Two cases of downward migration of the Günther vena caval filter are reported. Migration resulted in recurrent pulmonary embolism in one case; in the second, partial thrombosis of the filter precluded retrieval. Both patients were treated successfully by placement of a second Günther filter in the infrarenal vena cava. Until more experience with this filter is available, the authors recommend use of the 30-mm filter in medium- and large-size venae cavae. Radiographs should be obtained to check the position of the filter immediately and 1 week after placement. In addition anticoagulative therapy should be continued whenever possible.
