[Indications for the Greenfield filter at the distal side of renal veins. 15 cases].

Analysis of results of short- and medium-term use of 15 Greenfield's filters (GF) introduced distal to renal veins confirmed the good nephrologic tolerance and efficacy of partial interruption of suprarenal inferior vena cava. The surgical technic necessarily involves use of internal jugular vein (with the exclusion of femoral vein) and it is recommended to insert the GF in the retro-hepatic vena cava at a distance from renal veins. Review of 53 cases reported in the world literature indicates cases suitable for this procedure as being patients with severe thromboembolic accidents unable to be treated by direct surgery, fibrinolysis or by effective anticoagulation. Indications for use of a suprarenal GF include suprarenal extension of a caval thrombus or lack of efficacy of an anterior caval block proximal to renal veins. In these cases, that are rare and should remain so, the suprarenal Greenfield filter is the most satisfactory solution at the present time for ensuring the very poor vital prognosis of this very particular group of patients.