Pulmonary embolism from upper extremity deep vein thrombosis and the role of superior vena cava filters: a review of the literature

J Vasc Interv Radiol. 2010 Jun;21(6):779-87. doi: 10.1016/j.jvir.2010.02.021.


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.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Humans
  • Incidence
  • Pulmonary Embolism / mortality*
  • Pulmonary Embolism / prevention & control*
  • Risk Assessment
  • Risk Factors
  • Survival Analysis
  • Survival Rate
  • Vena Cava Filters / statistics & numerical data*
  • Vena Cava, Superior / surgery*
  • Venous Thrombosis / mortality*
  • Venous Thrombosis / surgery*