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  • Title: Pulmonary embolism from upper extremity deep vein thrombosis and the role of superior vena cava filters: a review of the literature.
    Author: Owens CA, Bui JT, Knuttinen MG, Gaba RC, Carrillo TC.
    Journal: J Vasc Interv Radiol; 2010 Jun; 21(6):779-87. PubMed ID: 20434365.
    Abstract:
    The placement of superior vena cava (SVC) filters to prevent pulmonary emboli (PE) from upper-extremity deep vein thrombosis (UEDVT), although controversial, has been reported. A total of 21 publications were identified that reported 209 SVC filters and documented eight major filter-related complications (3.8%), including four cardiac tamponades, two aortic perforations, and one recurrent pneumothorax. The in-hospital or 1-month mortality rate was 43.1%. Twenty-eight additional publications were identified that reported 3,747 cases of UEDVT. The rates of PE and associated mortality were 5.6% and 0.7%, respectively. Studies imaging both upper and lower extremities found deep vein thrombus 14.7 times more likely to occur in the lower extremities and the rate of PE from a lower-extremity thrombus to be 25.1%. The lack of evidence documenting the risk from UEDVT and the absence of data supporting the safety and efficacy of SVC filters bring their benefit into question.
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