Transvenous vena caval filtration and pulmonary embolectomy.

The diagnosis of deep vein thrombosis or pulmonary embolism can be made accurately using angiographic and radioisotopic techniques. Utilizing hemodynamic data, it is possible to classify patients with pulmonary embolism into five groups, which is helpful for planning therapy and assessing prognosis. Surgery for pulmonary embolism has evolved to include intraluminal methods of vena caval filtration for prevention of recurrent pulmonary embolism and transvenous extraction of pulmonary emboli. Though the majority of patients surviving pulmonary embolism can be managed medically with anticoagulation, a significant number will require surgical intervention. The development of transvenous methods allows effective emergency management of major pulmonary embolism, even in hospitals that do not have the capability for cardiopulmonary bypass.