Vena cava filter insertion and angiographic diagnosis of pulmonary embolism.

Insertion of a vena cava filter is a therapeutic alternative for patients in whom anticoagulation is not effective or appropriate. The Greenfield filter is associated with a 95% long-term patency rate and a low incidence of mortality or recurrent embolization. Although insertion can be done through the femoral or jugular route, the right femoral vein is the easiest, most direct approach to the inferior vena cava (IVC). Pulmonary arteriography remains the "gold standard" for establishing the diagnosis of pulmonary embolism.