Superior Vena Cava Filters for Upper-Extremity DVT

Deep venous thrombosis (DVT) of the upper extremity is less common than DVT of the lower extremity. Although there is controversy regarding the propensity of upper-extremity DVT to cause pulmonary embolism, a few reports have suggested a frequency of at least 10 percent; thus, some authorities recommend anticoagulation. This report from the Cleveland Clinic describes the placement of superior vena cava (SVC) filters in 41 patients with upper-extremity DVT for whom anticoagulation was unsuccessful or contraindicated.

In 36 of the 41 cases, the DVT was related to a central venous catheter; 26 patients had cancer or heart disease. A Greenfield filter was placed in 33 patients, and the most common access was the right femoral vein. There were no…