We inserted a Greenfield filter prophylactically in forty-two of
approximately 4,000 patients who were about to have a total hip or knee
replacement, or both, and who were at high risk for pulmonary embolism
(Group I). The filter was implanted postoperatively in twenty-four
additional patients who had thromboembolic complications or in whom
anticoagulation was contraindicated (Group II). None of the patients in
Group I and only one in Group II had a fatal pulmonary embolism. Use of the
Greenfield filter is a safe, easy, and effective method of preventing fatal
pulmonary embolism in selected patients: those who are at exceptionally
high risk for thromboembolism, as a method of preoperative prophylaxis;
those who have had a thromboembolism and in whom therapeutic
anticoagulation is contraindicated; and those who have complications
secondary to therapeutic anticoagulation.