Kirilcuk N N, Herget E J, Dicker R A, Spain D A, Hellinger J C, Brundage S I
Division of Trauma, Emergency, and Critical Care Surgery, Department of Surgery, Stanford University Medical Center, 300 Pasteur Dr., Room H-3680, Stanford, CA 94305, USA.
Am J Surg. 2005 Dec;190(6):858-63. doi: 10.1016/j.amjsurg.2005.08.009.
Despite significant risk for venous thromboembolism, severely injured trauma patients often are not candidates for prophylaxis or treatment with anticoagulation. Long-term inferior vena cava (IVC) filters are associated with increased risk of postphlebitic syndrome. Retrievable IVC filters potentially offer a better solution, but only if the filter is removed; our hypothesis is that the most of them are not.
This retrospective study queried a level I trauma registry for IVC filter insertion from September 1997 through June 2004.
One IVC filter was placed before the availability of retrievable filters in 2001. Since 2001, 27 filters have been placed, indicating a change in practice patterns. Filters were placed for prophylaxis (n = 11) or for therapy in patients with pulmonary embolism or deep vein thrombosis (n = 17). Of 23 temporary filters, only 8 (35%) were removed.
Surgeons must critically evaluate indications for IVC filter insertion, develop standard criteria for placement, and implement protocols to ensure timely removal of temporary IVC filters.
尽管严重创伤患者发生静脉血栓栓塞的风险很高，但他们往往不适合接受抗凝预防或治疗。长期下腔静脉（IVC）滤器与血栓后综合征风险增加有关。可取出的IVC滤器可能提供更好的解决方案，但前提是滤器要取出；我们的假设是大多数滤器并未取出。
这项回顾性研究查询了1997年9月至2004年6月期间I级创伤登记处中IVC滤器置入情况。
2001年可取出滤器出现之前置入了1个IVC滤器。自2001年以来，共置入了27个滤器，表明实践模式有所改变。置入滤器的目的是预防（n = 11）或用于肺栓塞或深静脉血栓形成患者的治疗（n = 17）。在23个临时滤器中，仅8个（35%）被取出。
外科医生必须严格评估IVC滤器置入的指征，制定置入的标准准则，并实施相关方案以确保及时取出临时IVC滤器。
