The Annals of Thoracic Surgery, Vol 26, 50-53, Copyright © 1978 by The Society of Thoracic Surgeons
Extraluminal or intraluminal inferior vena cava occlusion in pulmonary embolism
J Popovsky, J Edelstein, L Walzer, C Vlastou and C Ryan
Twenty-five cases of extraluminal and 47 of intraluminal inferior vena
caval (IVC) occlusion for management of pulmonary embolism were reviewed. A
comparison of results obtained with both methods suggests that the IVC
umbrella filter provides the safer, more reliable means of IVC interruption
in patients whose condition fulfills the criteria for caval occlusion. The
simplicity of this technique and the fact that it can be performed under
local anesthesia justify its consideration as the procedure of choice for
IVC occlusion and permit its use in severely ill patients. On the basis of
our positive findings, we now recommend that extraluminal occlusion be
reserved for patients in whom insertion of the IVC umbrella is technically
impossible.