Dalman R, Kohler T R
Department of Surgery, University of Washington School of Medicine, Seattle.
J Vasc Surg. 1989 Mar;9(3):452-4. doi: 10.1067/mva.1989.vs0090452.
A 69-year-old man with paradoxical embolism suffered a cerebral embolism despite treatment with anticoagulants and placement of a Greenfield filter. The open architecture of the filter allows it to maintain caval patency better than other mechanical devices, but this design also permits passage of emboli up to 3 mm in diameter. Although such small emboli do not produce symptoms in the pulmonary circuit, they can be devastating in the cerebral circulation. For this reason, the Greenfield filter may be inadequate treatment for paradoxical embolism. Ligation of the inferior vena cava is proposed as an alternative that provides better protection against small emboli.
一名69岁患有反常栓塞的男性，尽管接受了抗凝治疗并植入了格林菲尔德滤器，仍发生了脑栓塞。该滤器的开放式结构使其比其他机械装置能更好地保持腔静脉通畅，但这种设计也允许直径达3毫米的栓子通过。虽然如此小的栓子在肺循环中不会产生症状，但在脑循环中却可能具有破坏性。因此，格林菲尔德滤器对于反常栓塞可能是不充分的治疗方法。有人提出结扎下腔静脉作为一种替代方法，它能更好地预防小栓子。
