Girard P, Tardy B, Decousus H
Département Thoracique, Institut Mutualiste Montsouris, Paris, France.
Annu Rev Med. 2000;51:1-15. doi: 10.1146/annurev.med.51.1.1.
Interruption of the inferior vena cava (IVC) to prevent pulmonary embolism arising from venous thrombi in the lower extremities has become widely used since IVC filters became available about 30 years ago. However, reliable data regarding efficacy and safety of IVC filters are still lacking. The first controlled clinical trial of IVC filters demonstrated their effectiveness, but filters had no detectable impact on mortality and were associated with an increased risk of recurrent deep venous thrombosis. On the basis of the literature, indications for IVC interruption can be classified as accepted, debated, and debatable. The relevance of debated indications, more accurate identification of patients who remain "very high-risk" despite preventive or curative anticoagulant treatment, and selection of the most appropriate filter should be looked at in prospective clinical studies.
自大约30年前下腔静脉滤器问世以来，中断下腔静脉（IVC）以预防下肢静脉血栓引起的肺栓塞已被广泛应用。然而，关于下腔静脉滤器疗效和安全性的可靠数据仍然缺乏。下腔静脉滤器的第一项对照临床试验证明了其有效性，但滤器对死亡率没有可检测到的影响，并且与复发性深静脉血栓形成风险增加有关。根据文献，下腔静脉中断的适应症可分为公认的、有争议的和值得商榷的。前瞻性临床研究应探讨有争议适应症的相关性、更准确地识别尽管接受了预防性或治疗性抗凝治疗但仍处于“极高风险”的患者，以及选择最合适的滤器。
