Patients with nonfatal pulmonary emboli may be managed by administration of anticoagulants, by inferior vena caval ligation, or by one of a number of operations to partition the inferior vena cava (IVC),1-6 all of which methods have certain disadvantages. Anticoagulants carries the risk of further embolism and ligation or partition of IVC, even though blocking emboli arising from veins of the legs or pelvis of necessity requires general anesthesia and a fairly extensive operation. This report describes the long-term results of a new simplified method of IVC interruption by an intracaval prosthesis which is implanted intravenously under local anesthesia. Experimental studies and initial clinical experience was reported earlier.7,8 This procedure avoids a major surgical operation and can be performed with minimal risk even in critically ill patients with acute pulmonary embolism.
Materials and Methods
The intracaval prosthesis (Fig 1) is of an umbrella design and consists of six