Rosenthal David, Swischuk James L, Cohen Sidney A, Wellons Eric D
Department of Vascular Surgery, Atlanta Medical Center, Atlanta, GA, USA.
Vascular. 2005 Sep-Oct;13(5):286-9. doi: 10.1258/rsmvasc.13.5.286.
The purpose of this article is to describe our experience with the retrievable OptEase inferior vena cava filter (IVCF) (Cordis Corporation, Miami Lakes, FL) in the prevention of pulmonary embolus (PE). Forty patients (24 men, age range 15-85 years, mean age 38 years) who were at temporary risk of PE underwent insertion and retrieval of the OptEase IVCF at two institutions. Eleven patients were treated with filter implantation and subsequent repositioning in the inferior vena cava (IVC) to extend implantation time. All patients were followed up for 24 hours after retrieval, with additional follow-up at the physician's discretion. Forty patients had successful filter insertion. Two patients who underwent intravascular ultrasound guidance for filter deployment required filter repositioning within 24 hours owing to inadvertent placement in the right common iliac vein. All 40 patients underwent successful filter retrieval with no adverse events. In those patients who did not undergo IVCF repositioning, the time to retrieval ranged from 3 to 48 days (mean +/- SD 16.38 +/- 7.20 days). One patient had a successful retrieval at 48 days, but all other retrieval experiences were performed within 23 days. The second strategy involved implantation, with repositioning at least once before final retrieval. This latter strategy occurred in 11 patients, and the time to first capture ranged from 4 to 30 days (mean +/- SD 13.82 +/- 6.13 days). No symptomatic PE, IVC injury or stenosis, significant bleeding, filter fracture, or filter migration was observed. In this feasibility study, the OptEase IVCF prevented symptomatic PE, was safely retrieved or repositioned up to 48 days after implantation, and served as an effective bridge to anticoagulation. In patients who require extended IVCF placement, the OptEase IVCF can be successfully repositioned within the IVC, thereby extending the overall implantation time of this retrievable IVCF.
本文旨在描述我们使用可回收的OptEase下腔静脉滤器(IVCF)(科迪斯公司,迈阿密湖,佛罗里达州)预防肺栓塞(PE)的经验。40例有PE临时风险的患者(24例男性,年龄范围15 - 85岁,平均年龄38岁)在两家机构接受了OptEase IVCF的植入和取出。11例患者接受了滤器植入并随后在下腔静脉(IVC)重新定位以延长植入时间。所有患者在取出后随访24小时,并根据医生的判断进行额外随访。40例患者滤器植入成功。2例在血管内超声引导下进行滤器置入的患者,由于无意中放置在右髂总静脉,需要在24小时内重新定位滤器。所有40例患者均成功取出滤器,无不良事件发生。在未进行IVCF重新定位的患者中,取出时间为3至48天(平均±标准差16.38±7.20天)。1例患者在48天时成功取出,但所有其他取出均在23天内完成。第二种策略是植入,在最终取出前至少重新定位一次。后一种策略发生在11例患者中,首次捕获时间为4至30天(平均±标准差13.82±6.13天)。未观察到有症状的PE、IVC损伤或狭窄、严重出血、滤器断裂或滤器移位。在这项可行性研究中,OptEase IVCF预防了有症状的PE,在植入后长达48天可安全取出或重新定位,并作为抗凝的有效桥梁。在需要延长IVCF放置时间的患者中,OptEase IVCF可在IVC内成功重新定位,从而延长这种可回收IVCF的总体植入时间。