Lang W, Schweiger H, Hofmann-Preiss K
Department of Surgery, Erlangen University Hospital, Germany.
J Cardiovasc Surg (Torino). 1992 Sep-Oct;33(5):573-8.
Digital subtraction venacavography (DSV) as a follow-up examination was performed in 46 patients after placement of a standard stainless steel Greenfield vena caval filter (SGF). DSV is an exact method of visualizing the lumen of the inferior vena cava as well as intraluminal or captured thrombi. Eccentric filters with an angulation of more than 15 degrees were found in 8 patients causing a higher risk of pulmonary embolism from smaller emboli and propagating thrombi. Penetration of the caval wall by filter struts was however frequent (41%), without any damage to adjacent structures as demonstrated by CT scans. The long-term caval patency rate was 90%, with 4 cases of caval thrombosis. Two patients with an occluded inferior vena cava showed no venostasis. Although changes of the filter position usually remain asymptomatic, regular follow-up examinations seem necessary to recognize any impairment of the filter's clot trapping efficiency. Filters should only be used in patients with a risk of recurrent pulmonary embolism despite anticoagulation and patients with contraindications to anticoagulation therapy.
对46例植入标准不锈钢格林菲尔德下腔静脉滤器（SGF）的患者进行了数字减影静脉造影（DSV）作为随访检查。DSV是一种精确显示下腔静脉管腔以及腔内或捕获血栓的方法。在8例患者中发现角度大于15度的偏心滤器，这会使较小栓子和蔓延血栓导致肺栓塞的风险更高。然而，滤器支柱穿透腔壁的情况很常见（41%），CT扫描显示对相邻结构没有任何损伤。长期腔静脉通畅率为90%，有4例腔静脉血栓形成。2例下腔静脉闭塞的患者未出现静脉淤滞。尽管滤器位置的改变通常无症状，但定期随访检查似乎有必要，以识别滤器捕获血栓效率的任何损害。滤器仅应用于尽管进行了抗凝但仍有复发性肺栓塞风险的患者以及有抗凝治疗禁忌证的患者。
