Millward S F, Oliva V L, Bell S D, Valenti D A, Rasuli P, Asch M, Hadziomerovic A, Kachura J R
Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, Canada.
J Vasc Interv Radiol. 2001 Sep;12(9):1053-8. doi: 10.1016/s1051-0443(07)61590-5.
To report data collected by the Canadian Registry of the Günther Tulip Retrievable Filter (GTF).
Between February 1998 and December 2000, 90 patients at eight hospitals underwent implantation of 91 GTFs. There were 45 male patients and 45 female patients, age 17-88 years, with a mean age of 49 years. Indications for filter placement were pulmonary embolism (PE) or deep vein thrombosis (DVT) with a contraindication to anticoagulation in 83 patients, prophylaxis after massive PE in one, prophylaxis for proximal free-floating thrombus in one, and prophylaxis with no DVT or PE in six patients (major trauma, n = 4; high preoperative risk, n = 2). GTF retrieval was attempted in selected patients from a right internal jugular vein approach.
One GTF was inadvertently placed in the right iliac vein and could not be retrieved. There were no other major placement complications. GTF retrieval was attempted in 52 patients (53 GTFs); 52 GTFs were successfully retrieved from 51 patients. Implantation times were 2-25 days (mean, 9 d). Of these 51 patients, 37 underwent follow-up for 5-420 days (mean, 103 d) after filter retrieval. Four patients (8% of retrieved GTFs) required reinsertion of a permanent filter 17-167 days (mean, 78 d) after GTF retrieval as a result of bleeding from anticoagulation (n = 2) or because the patient required further surgery (n = 2). One other patient had recurrent DVT 230 days after retrieval; no PE or other complication was documented in the retrieval group. GTFs were not retrieved from 39 patients for various reasons. Of these 39 patients, 25 underwent follow-up 7-420 days (mean, 85 d) after filter placement. Two patients developed filter occlusion (5%); no other complications were documented.
The GTF has a broad range of utility: it can be used as a permanent filter or retrieved after implantation periods of 15 days and possibly longer. However, indications for retrieval require further study, as does the maximum implantation time.
报告加拿大冈瑟郁金香可回收滤器（GTF）注册研究收集的数据。
1998年2月至2000年12月期间，8家医院的90例患者植入了91枚GTF。其中男性患者45例，女性患者45例，年龄17 - 88岁，平均年龄49岁。放置滤器的指征为：83例患者存在肺栓塞（PE）或深静脉血栓形成（DVT）且有抗凝禁忌证；1例为大面积PE后的预防；1例为近端游离血栓的预防；6例患者无DVT或PE（重大创伤，n = 4；术前高风险，n = 2）。对部分患者尝试经右颈内静脉途径取出GTF。
1枚GTF误置于右髂静脉且无法取出。无其他重大放置并发症。对52例患者（53枚GTF）尝试取出GTF；52枚GTF成功从51例患者体内取出。植入时间为2 - 25天（平均9天）。在这51例患者中，37例在滤器取出后接受了5 - 420天（平均103天）的随访。4例患者（取出的GTF的8%）在GTF取出后17 - 167天（平均78天）因抗凝出血（n = 2）或患者需要进一步手术（n = 2）而需要重新植入永久性滤器。另1例患者在取出后230天发生复发性DVT；取出组未记录有PE或其他并发症。39例患者因各种原因未取出GTF。在这39例患者中，25例在滤器放置后接受了7 - 420天（平均85天）的随访。2例患者发生滤器闭塞（5%）；未记录有其他并发症。
GTF具有广泛的用途：它可作为永久性滤器使用，也可在植入15天及可能更长时间后取出。然而，取出的指征以及最长植入时间都需要进一步研究。
