RESUMO
E apresentada a experiência desenvolvida na Clínica de Cirurgia Vascular do Hospital Naval Marcílio Dias com a análise de 29 pacientes acometidos de embolia pulmonar e que foram avaliados visando a indicação de filtragem da veia cava. Vinte deles foram tratados clinicamente e em nove foi aplicado o filtro de Greenfield. Dos pacientes tratados clinicamente, seis apresentavam falência concomitante de múltiplos órgãos, vindo a falecer; quatro tiveram recidiva da embolia, tendo ocorrido um óbito. Dos nove pacientes nos quais foram aplicados os filtros, todos eram portadores de embolia pulmonar maciça. Todos os filtros foram introduzidos através da veia jugular interna direita, sob anestesia local, para dissecção da mesma. Não houve complicação durante o procedimento. Dos nove pacientes, sete evoluíram bem e dois vieram a falecer devido ao impacto da embolia inicial. Não houve sinais de recidiva da embolia neste grupo. Fazemos referência a 10 tipos de filtros de veia cava existentes na literatura e, por fim, discutimos as características e a aplicabilidade dos cinco filtros mais usados nos diversos centros médicos do mundo. Relatamos a experiência desenvolvida com cada um deles em outros centros médicos e a nossa própria experiência na aplicação do filtro Greenfield em nove pacientes. Concluímos considerando que, apesar de ainda não ter sido fabricado o filtro ideal, os procedimentos clássicos de ligadura, clipagem e plicatura da veia cava, que provocarem altos índices de complicações e baixa efetividade na profilaxia da embolia pulmonar, devem ser substituídos, salvo raras exceções, pêlos modernos dispositivos de filtragem da mesma veia.

SUMMARY
The authors present the result of the studies developed in 29 patients suffering from pulmonary embolism treated the Surgical Vascular Clinic of Marcílio Dias Naval Hospital. These patients were analysed to distinguish those who really had indication of vena cava filter placement. Twenty of them were clinically treated and in nine was appiied the Greenfield Filter. Among the patients clinically treated six of the m suffered failure of multiple organs at the same time and the result was their death, four showed recurrence of embolism and among them one died, and ten had good evolution. Ali the nine patients to whom the filter was appiied suffered from massive pulmonary embolism. Ali filters were placed surgically via righ internal jugular vein under local anesthesia to provide its dissection. During the procedure no complications occured. The procedure was successfui in seven out of the nine patients. Two of them died because of the initial embolism shock. No recurrence of embolism in this group was observed to now. They refer to 10 different types of cavai vena filters wich are mentioned in medical literature and finaly present characteristics and appiicability of the fíve most used in various medical centers in the worid. They relate the experience developed with each type by others medical centers and included their experience in the appiication of the Greenfield Filter in nine patients. Finally, they concluded that although an ideal filter hasn't been producted, the classical procedures of ligation, clipation and suture plication of the vena cava still shouldn't be appiied, since they provoke high incidence of complications and low effectiveness of profilaxy of pulmonary embolism. So, they suggest that these classical procedures should be substituted, if possible, by modem contrivances of filtering of the same vein.