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乔纳斯研究:Cordis OptEase下腔静脉滤器可回收性评估

The Jonas study: evaluation of the retrievability of the Cordis OptEase inferior vena cava filter.

作者信息

Oliva Vincent L, Szatmari Ferenc, Giroux Marie-France, Flemming Bruce K, Cohen Sidney A, Soulez Gilles

机构信息

Department of Radiology, Centre Hospitalier de l'Université de Montréal, Quebec, Canada.

出版信息

J Vasc Interv Radiol. 2005 Nov;16(11):1439-45; quiz 1445. doi: 10.1097/01.RVI.0000171699.57957.C7.

Abstract

PURPOSE

To evaluate the success, safety, and efficacy of the retrieval of the OptEase Permanent/Retrievable Vena Cava Filter (Cordis, Warren, NJ), when implanted for temporary protection against venous thromboembolism.

MATERIALS AND METHODS

This prospective, multicenter, non-randomized study enrolled 27 patients who needed temporary protection against pulmonary embolism in whom the intent at the time of filter insertion was retrieval of the OptEase filter. Patients presented with deep venous thrombosis (n = 17), pulmonary embolism (PE) (n = 6), and high risk for PE without thromboembolic disease (n = 4). Assessments included duplex sonography of the access site performed within 24 hours of device implantation and retrieval. All patients underwent cavography before and after filter placement and filter retrieval. Contrast-enhanced computed tomography (CT) of the abdomen and clinical follow-up was performed at 1 month after device retrieval.

RESULTS

Of the 27 enrolled patients, 21 patients (77.8%) met the criteria for retrieval and all 21 patients (100%) had filters successfully retrieved with no associated adverse events. Retrieval was not attempted in six patients as a result of ongoing contraindication to anticoagulation (n = 3), large trapped thrombi within the filter (n = 2), and poor patient prognosis (n = 1). Time to retrieval ranged from 5 to 14 days with a mean implantation time of 11.1 days +/- 1.82. No symptomatic pulmonary embolism, vena cava wall injury, vena cava stenosis, significant bleeding, filter fracture, or filter migration was observed. Nineteen of the 21 patients (90.5%) were followed for 1-month post-retrieval with no device-related adverse events or symptomatic PE. Caval patency was documented in 18 of these 19 patients with CT. Two patients were lost to follow-up, and one patient refused to undergo CT examination.

CONCLUSION

The OptEase permanent/retrievable vena cava filter can be safely and successfully retrieved up to 14 days in patients who no longer require inferior vena cava filter protection against pulmonary embolism.

摘要

目的

评估OptEase永久/可回收腔静脉滤器(Cordis,沃伦,新泽西州)植入后用于临时预防静脉血栓栓塞时回收的成功率、安全性和有效性。

材料与方法

这项前瞻性、多中心、非随机研究纳入了27例需要临时预防肺栓塞且在植入滤器时打算回收OptEase滤器的患者。患者表现为深静脉血栓形成(n = 17)、肺栓塞(PE)(n = 6)以及无血栓栓塞性疾病但有PE高风险(n = 4)。评估包括在装置植入和回收后24小时内对穿刺部位进行的双功超声检查。所有患者在滤器置入前、回收前后均进行了腔静脉造影。在装置回收后1个月进行腹部对比增强计算机断层扫描(CT)和临床随访。

结果

在27例纳入患者中,21例(77.8%)符合回收标准,所有21例(100%)均成功回收滤器,且无相关不良事件。6例患者因抗凝存在持续禁忌证(n = 3)、滤器内有大量被困血栓(n = 2)以及患者预后不良(n = 1)而未尝试回收。回收时间为5至14天,平均植入时间为11.1天±1.82天。未观察到有症状的肺栓塞、腔静脉壁损伤、腔静脉狭窄、严重出血、滤器断裂或滤器移位。21例患者中的19例(90.5%)在回收后随访1个月,无与装置相关的不良事件或有症状的PE。这19例患者中有18例经CT证实腔静脉通畅。2例患者失访,1例患者拒绝接受CT检查。

结论

对于不再需要下腔静脉滤器预防肺栓塞的患者,OptEase永久/可回收腔静脉滤器在长达14天内可安全、成功回收。

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