Prevention of further embolization can best be accomplished with adequate anticoagulation with heparin. In patients with contraindications to anticoagulation or with recurrent pulmonary emboli while maintaining a therapeutic partial thromboplastin time, some form of vena caval interruption, with either the placement of an intraluminal filter or an extraluminally applied serrated clip, should be undertaken. Filter devices such as the Greenfield filter have rates of preventing significant recurrent emboli of 95 per cent and long-term patency of 97 per cent. Emboli as small as 3 mm can be successfully trapped. These devices can be placed from remote access sites via percutaneous techniques under local anesthesia with a low morbidity and mortality.

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