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Old 05-10-2011, 05:38 PM
 
1 posts, read 4,421 times
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Quote:
Originally Posted by John1960 View Post
Hi, Have you ever got a Greenfield Filter put in a vein to pervent blood clots from going into your lungs?

My local hospital wanted me to have this filter put in a main vein from my heart to pervent blood clots from going to my lungs. I have not had this done yet.

John
Yes, I had it in 1996 when is was a very new procedure. They now have ones that can be removed to clean them out if they get very plugged. It could save your life. San Diego University Hospital is an excellent place!!! They are a teaching hospital and used to be up on all the new things. (probably still are) I have a severe case of vericouse veins, not sure if the filter is plugged and causing it? They all seem to come from the top of my legs and are very pronounced. Ask you Dr. The one I have cannot be taken out.
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Old 05-18-2011, 05:20 AM
 
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I have had a Greenfield filter since 1992.....My question is; is it still working....I am on coumadin since they found a clot in my left leg......So how do I know if the filter is still working...and should I continue on the coumadin.....thank you Carol
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Old 05-18-2011, 06:46 AM
 
Location: Durham UK
2,031 posts, read 4,499,927 times
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Quote:
Originally Posted by cardinalohio View Post
My husband has been on Warfarin since 1990. It is well regulated. His INR kept between 2 & 3. He asked today at his Dr visit about a Greenfield filter. The Dr said they are not recommended and in his case not needed.
I worked in the UK as a Clinical Nurse Specialist in anticoagulation care- ie we managed over 7,000 patients requiring warfarin and/or Low molecular weight heparin for DVT and PE.

Some were life long after having several episodes of DVT, maybe due to inherited thrombophylias, cancer etc.
Others required LMWH during pregnancy, followed by warfarin after delivery for 3-6 months.

After eading this thread I was slightly puzzled as to why people who had had a single episode of DVT/PE, maybe due to factors such as surgery or pregnancy were sitting around with lifelong VCFs in, and appeared never to have been anticoagulated with warfarin.

I did some research and found that the evidence from clinical trials for the use of Vena Caval filters is very limited, but what evidence there is shows that

1. Unless there is a HUGE contraindication to anticoagulation, in most cases VCF insertion should only be considered if anticoagulation has failed ie pt has a repeated episode of DVT/PE whilst therapeutically anticoagulated ie INR within therapeutic range of 2-3 (usually)

2. There is some evidence to suggest that VCFs without the addition of warfarin can lead to clot formation (around the filter) compared to patients treated with VCF and warfarin therapy or with warfarin alone.

3. The VCF isn't going to protect against DVT -which is where the majority of PEs originate. Warfarin will do that.
In those that really do require a lifelong VCF (and this is where there really is lack of evidence) the addition of warfarin should be considered.

4studies showed an increased number of DVTs (almost twice as many) in VCF alone, compared to pts who were anticoagulated, however the incidence of PE may be lower in the VCF group.(different studies had different results, presumably due to recruitment of pts with different case scenarios)Most importantly, there was no difference in mortality between the 2 groups.

5. VCFs require periodic monitoring (pref' by the person who inserted it). They can move! For some removable devices there is a limit to how long after insertion they can be removed

Seems to me that sticking the VCF in may be a convenience/cost choice, which may or may not have been discussed with the patient.
Warfarin, however costs pennys, but the monitoring costs need to be considered.
Also, warfarin can be a dangerous drug if it's not monitored and dosed correctly, and patients don't follow the do's and don'ts, but if it's done well, it works well!
Maybe it's easier to stick a VCF in and forget about it, even though it may not be required or useful anymore.


Here's a link to the most up to date guidelines from the British Clinical Standards in Haematology (the guidelines we followed as CNS as haematologists manage DVT/PE patients longterm in the UK)
Lots of medical jargon-sorry, but at least it's backed by evidence from the limited research there is.
Happy to try and answer any questions if I can!
http://www.bcshguidelines.com/docume...s_bjh_2006.pdf


Also from the (US) Society of Interventional Radiology
http://www.sirweb.org/misc/Guidelines_filters.pdf
[SIZE=1][SIZE=1] [/SIZE]
[SIZE=1][SIZE=3]1. The primary means of therapy and prophylaxis of VTE are pharmacologic[/SIZE]
Moderator cut: too long a quote, 1-2 sentences and link please

Last edited by SouthernBelleInUtah; 05-28-2011 at 10:27 AM..
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Old 05-28-2011, 10:11 AM
 
1 posts, read 4,439 times
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RECENTLY HAD ONE PUT IN MY VENA CAVA. WAS AWAKE BUT GIVEN MEDS. NO PAIN, THERE WAS NOTHING TO IT! I ACTUALLY CALLED MY CHILDREN TO TELL THEM I WAS GOING IN TO SURGERY TO HAVE THIS FILTER PLACED INTO MY HEART AND IT SOUNDED SO MAJOR AND I WAS TEARY LIKE I MIGHT DIE BLAH BLAH. YES, ANY SURGERY IS BAD, BUT I AM TELLING YOU IT WAS NOTHING! I HAVE MANY CLOTS AND AM NOT A CANDIDATE FOR BLOOD THINNERS. LISTEN TO YOUR DR. OR GET ANOTHER OPINION IF YOU ARE UNSURE. PRAY ABOUT IT. GOD BLESS!
if i have duplicated my post, i apologize. i ain't so swooft at this stuff
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Old 06-25-2011, 06:55 AM
 
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I was in a near fatal car accident 6 years ago. I'm just now finding out there's a Greenfield filter in my body! I am worried for my life now. Sigh.. Will this filter effect me in the future? Can I ever get pregnant without complications??
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Old 06-29-2011, 10:55 AM
 
Location: Durham UK
2,031 posts, read 4,499,927 times
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Quote:
Originally Posted by LalaSim2012 View Post
I was in a near fatal car accident 6 years ago. I'm just now finding out there's a Greenfield filter in my body! I am worried for my life now. Sigh.. Will this filter effect me in the future? Can I ever get pregnant without complications??
If you developed a clot/c;ots purely because of the trauma and immobility, then I would be seeing about having it removed.
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Old 06-29-2011, 10:56 AM
 
Location: Durham UK
2,031 posts, read 4,499,927 times
Reputation: 1127
Quote:
Originally Posted by RN4GOD View Post
RECENTLY HAD ONE PUT IN MY VENA CAVA. WAS AWAKE BUT GIVEN MEDS. NO PAIN, THERE WAS NOTHING TO IT! I ACTUALLY CALLED MY CHILDREN TO TELL THEM I WAS GOING IN TO SURGERY TO HAVE THIS FILTER PLACED INTO MY HEART AND IT SOUNDED SO MAJOR AND I WAS TEARY LIKE I MIGHT DIE BLAH BLAH. YES, ANY SURGERY IS BAD, BUT I AM TELLING YOU IT WAS NOTHING! I HAVE MANY CLOTS AND AM NOT A CANDIDATE FOR BLOOD THINNERS. LISTEN TO YOUR DR. OR GET ANOTHER OPINION IF YOU ARE UNSURE. PRAY ABOUT IT. GOD BLESS!
if i have duplicated my post, i apologize. i ain't so swooft at this stuff
curious as to why you can't take warfarin (blood thinners)?
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Old 08-29-2011, 10:10 AM
 
1 posts, read 4,175 times
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I had a greenfield filter inserted after massive PE's in both lungs after a hip replacement 17 years ago. I was in the hospital for a total of 5 weeks. I was given Warfarin to disolve the clots and then the filter was put in. It has saved my life. I was too young to be on blood thinners as the Dr.s said. I have had no problems since and there was no pain. It will be in for life, and cannot be dislodged.
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Old 12-19-2011, 05:23 AM
 
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I have a 36 year history of blood clots in my legs. I have been diagnosed with lymphodema. I was taking blood thinners but developed a huge ulcer in my stomach and was taken off cumaden(for blood clots)because my doctor was worried the ulcer would start bleeding so he had the Greenfield Filter put in. My blood clots have become worse in the last 6 months. I now have blood clots in both legs from my ankles to my thighs. My doctor is trying to dissolve the clots but has realized that I am allergic to cumaden. My doctor does not discuss options with me and is quite hard to talk to. I am worried that with the blood clots getting bigger and not being able to take cumaden that the filter might become severly clogged. Has anyone heard of any instances where the filter has failed or not worked properly?
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Old 01-20-2012, 04:18 PM
 
2 posts, read 6,079 times
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I was hospitilized for a week because they found blood clots in both my legs. The blood clots prevented to the blood to flow to my foot and ended up with a gangrene toe which has to be amputated. Went to see a vascular surgeon who told me i did not need a greenfield filter, but after seeing my podiatrist and speaking to the nurse at the hospital they cannot understand why i do not have a filter. It upsets me because i would feel alot better having that filter than having to worry all the time about clots, are they traveling through my body. I think a second opinion is in order.
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