Bull P G, Mendel H, Schlegl A
First Department of Surgery, Krankenhaus Wien-Lainz, Vienna, Austria.
J Vasc Interv Radiol. 1992 May;3(2):395-9. doi: 10.1016/s1051-0443(92)72052-1.
The mechanical stability of the Günther filter, caval patency, and complications related to filter placement were evaluated in 33 patients. Indications for placement included recurrent pulmonary embolism despite anticoagulation (n = 24) and contraindication to anticoagulation (n = 5). Four filters were placed prior to pulmonary lysis. Filters were positioned via the transfemoral route in 31 patients and via the transjugular route in two. Placement was complicated by pneumothorax in one case and faulty filter position in another. Patients were followed up for 52 months (mean, 12.1 months). Four patients died of nonembolic complications; three patients were lost to follow-up. Among the remaining 26 patients, caudal migration (3-6 cm) occurred in 19 (73%), cephalic migration into the atrium occurred in one, the inferior vena cava occluded in five, and struts perforated the caval wall in five. Pulmonary embolism recurred in one patient. In 11 cases, thrombus caught inside the basket was revealed with computed tomography; in one case a 7-cm floating thrombus was observed. The authors conclude that use of the Günther filter cannot be recommended because of the high prevalence of complications.
对33例患者评估了 Günther 滤器的机械稳定性、下腔静脉通畅情况以及与滤器置入相关的并发症。置入滤器的指征包括尽管进行了抗凝治疗仍发生复发性肺栓塞（n = 24）以及抗凝治疗的禁忌证（n = 5）。4例滤器在肺血栓溶解术前置入。31例患者经股静脉途径置入滤器，2例经颈静脉途径置入。1例出现气胸并发症，另1例滤器位置不当。患者随访52个月（平均12.1个月）。4例患者死于非栓塞性并发症；3例患者失访。其余26例患者中，19例（73%）发生尾端移位（3 - 6 cm），1例头端移位至心房，5例下腔静脉闭塞，5例滤器支脚穿透腔静脉壁。1例患者复发肺栓塞。11例通过计算机断层扫描发现滤器内捕获血栓；1例观察到7 cm漂浮血栓。作者得出结论，由于并发症发生率高，不建议使用 Günther 滤器。
