Jones T K, Barnes R W, Greenfield L J
Ann Thorac Surg. 1986 Dec;42(6 Suppl):S48-55. doi: 10.1016/s0003-4975(10)64643-7.
Prevention is the best therapy for deep venous thrombosis, but when this fails, prompt diagnosis and appropriate treatment can usually avoid lethal pulmonary embolism. Anticoagulation is the preferred treatment for thromboembolic disease because it prevents lethal pulmonary embolism and also arrests the underlying thrombotic process. However, in specific patients with documented pulmonary embolism or deep venous thrombosis, or who are at high risk that either of these will develop, anticoagulation therapy may be contraindicated, may fail to control the thrombotic process, or may offer inadequate protection from lethal pulmonary embolism. In these instances, or when a previous mechanical attempt has failed to prevent pulmonary embolism from a caval source, a Greenfield filter should be considered. The available information on the natural history of patients in these specific categories and subcategories is reviewed, and the indications for and timing of Greenfield filter placement are explained.
预防是深静脉血栓形成的最佳疗法，但如果预防失败，及时诊断和恰当治疗通常可避免致命性肺栓塞。抗凝是血栓栓塞性疾病的首选治疗方法，因为它可预防致命性肺栓塞，还能阻止潜在的血栓形成过程。然而，对于已确诊肺栓塞或深静脉血栓形成的特定患者，或有发生上述任何一种疾病高风险的患者，抗凝治疗可能存在禁忌证，可能无法控制血栓形成过程，或可能无法充分预防致命性肺栓塞。在这些情况下，或者当先前的机械性尝试未能预防来自腔静脉的肺栓塞时，应考虑置入格林菲尔德滤器。本文回顾了这些特定类别和亚类患者自然病史的现有信息，并解释了格林菲尔德滤器置入的适应证和时机。
