Failure of the intracaval filter of Günther to prevent recurrence of pulmonary embolism--report of two cases.

Two out of nine patients in which inferior vena cava interruption was performed with a Günther filter developed a recurrent pulmonary embolism. In both cases, the filter had moved down and the anchoring legs had perforated the wall of the vena cava. The source of the pulmonary embolism was a clotted basket filter. Anticoagulation was given for two weeks in one patient and six months in the other after insertion of the filter, but it had been stopped before the thrombotic event leading to the recurrent pulmonary embolism. The formation of the thrombi had probably been caused by the migration of the filter and the subsequent perforation, which may have been facilitated by the cessation of the anticoagulation.