Search

Since the first vena caval filter was inserted at St. Joseph's Hospital in 1979, 18 similar procedures have been performed. A review of these cases was conducted in which the indications for and site of insertion, associated diagnostic and radiographic studies, complications, and mortality were summarized. The data reveal a mortality rate of 11%, owing primarily to the use of the filter in hemodynamically unstable patients with massive pulmonary emboli. This figure suggests that vena caval filters should only be used as a truly prophylactic measure, limiting the indications for insertion to failures of or contraindications to anticoagulation, as well as possible consideration as prophylaxis in high risk patients or those with "free floating" thrombus above the inguinal ligament. Such failures of anticoagulation and complications of overtreatment can be minimized through an understanding of the variable response to anticoagulants and the recognition of the need for accurate, frequent monitoring of anticoagulant therapy. [ABSTRACT FROM AUTHOR]

Presents a case of 76-year-old white woman with embolism involving the superior mesenteric artery. Difficulty in the diagnosis of the disease; Signs and symptoms; Description of arteriotomy.