Greenfield L J, Peyton M D, Brown P P, Elkins R C
Ann Surg. 1974 Oct;180(4):461-8. doi: 10.1097/00000658-197410000-00011.
Clinical pulmonary embolic disease was categorized into four classes according to hemodynamic and respiratory effects of the occlusion at the time of diagnosis. A new approach to management of massive embolization (Class III and IV) by transvenous catheter embolectomy was attempted in ten patients with initial success in eight. Three additional deaths occurred postoperatively, two from recurrent embolization prior to vena caval plication. In view of this preventable complication, a wire filter device was developed for insertion at the time of embolectomy. The filter has also been utilized in 15 additional patients with lesser degrees of embolization (Class II). The conal shape of the device permits preservation of flow after embolic capture and followup venacavagrams in nine patients up to 20 months postoperative shows patency in all. Complications occurred in both groups related both to the underlying disorder and to the catheter technics.
临床肺栓塞疾病根据诊断时阻塞的血流动力学和呼吸效应分为四类。对10例大面积栓塞（III级和IV级）患者尝试采用经静脉导管取栓术进行新的治疗方法，8例初获成功。术后又有3例死亡，2例死于腔静脉折叠术前的复发性栓塞。鉴于这种可预防的并发症，开发了一种金属丝过滤装置，以便在取栓时插入。该过滤器还用于另外15例栓塞程度较轻（II级）的患者。该装置的锥形形状允许在栓子捕获后保持血流，9例患者术后长达20个月的随访腔静脉造影显示全部通畅。两组均发生了与基础疾病和导管技术相关的并发症。
