Terhaar Olaf Alfons, Lyon Stuart Macalister, Given Mark Frank, Foster Anne Elizabeth, Mc Grath Frank, Lee Michael J
Department of Academic Radiology, Beaumont Hospital and Royal College of Surgeons Medical School, Beaumont Road, Dublin 9, Ireland.
J Vasc Interv Radiol. 2004 Nov;15(11):1257-62. doi: 10.1097/01.RVI.0000134497.50590.E2.
To evaluate the Gunther Tulip vena cava filter with regard to ease of placement, complications, and retrieval over long time periods.
In 53 patients (ratio of men to women, 24:29; mean age, 52.8 years) retrievable Gunther Tulip filters (Vena Cava M Reye Filter Set; William Cook Europe, Denmark) were inserted. Indications included planned major surgery with recent pulmonary embolus or high pulmonary embolus risk (n = 16), extensive ilio-femoral thrombus (n = 11), deep vein thrombosis with anticoagulant complications (n = 9), breakthrough pulmonary embolus despite anticoagulant therapy (n = 4), and contraindication to anticoagulant therapy (n = 13). All patients were followed-up for immediate and long-term complications.
Fifty-three filters were successfully placed in 52 of 53 patients, yielding a success rate of 98.1%. Nineteen patients underwent attempted retrieval of their filter. Sixteen of 19 retrieval procedures were successful (84%). In three patients, the filter could not be removed on attempted retrieval (extensive filter thrombus in two patients and attachment to the wall in one patient). One patient received two filters, which were both successfully retrieved at a later date. Median implantation time for retrievable filters was 34 days (range, 7-126 days). Mean follow-up for patients with permanent filters was 13 months. Two major complications (pneumothorax and break through pulmonary embolus) and three minor complications (right internal jugular vein thrombosis in two patients and transient Horner's Syndrome in one patient) were recorded.
Insertion and retrieval of filters is safe and feasible. Preliminary data suggest that Gunther Tulip filter retrieval is feasible over and above the manufacturer's recommended retrieval interval of 14 days.
评估Gunther Tulip下腔静脉滤器在放置的难易程度、并发症及长期取出方面的情况。
对53例患者（男女比例为24:29；平均年龄52.8岁）植入可取出的Gunther Tulip滤器（Vena Cava M Reye Filter Set；丹麦威廉库克欧洲公司）。适应证包括近期有肺栓塞或高肺栓塞风险的计划性大手术（n = 16）、广泛的髂股静脉血栓形成（n = 11）、抗凝治疗出现并发症的深静脉血栓形成（n = 9）、抗凝治疗后仍发生的突破性肺栓塞（n = 4）以及抗凝治疗禁忌证（n = 13）。对所有患者进行即刻和长期并发症的随访。
53例患者中有52例成功植入53枚滤器，成功率为98.1%。19例患者尝试取出滤器。19例取出操作中有16例成功（84%）。3例患者在尝试取出时未能取出滤器（2例患者滤器有广泛血栓形成，1例患者滤器附着于血管壁）。1例患者植入了2枚滤器，均在之后成功取出。可取出滤器的中位植入时间为34天（范围7 - 126天）。植入永久性滤器患者的平均随访时间为13个月。记录到2例主要并发症（气胸和突破性肺栓塞）和3例次要并发症（2例患者右侧颈内静脉血栓形成，1例患者出现短暂性霍纳综合征）。
滤器的植入和取出安全可行。初步数据表明，Gunther Tulip滤器在超过制造商推荐的14天取出间隔后仍可取出。
