Yamagami Takuji, Kato Takeharu, Hirota Tatsuya, Yoshimatsu Rika, Matsumoto Tomohiro, Nishimura Tsunehiko
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-chyo, Kawaramachi-Hirokoji, Kamigyo, Kyoto 602-8566, Japan.
Cardiovasc Intervent Radiol. 2007 Mar-Apr;30(2):226-31. doi: 10.1007/s00270-006-0166-9.
To evaluate the feasibility and safety of withdrawal of a Gunther tulip retrievable vena cava filter (GTF).
Between June 2001 and December 2005, at our institution 86 GTFs were implanted for temporary caval filtration in 59 patients (37 women, 22 men; mean age 59.3 years, range 18-87 years). For GTFs retrieved thereafter, we retrospectively reviewed the following parameters: rate of success in retrieval, degree of trapped thrombus in the filter, and complications during retrieval.
Worsening of or new development of pulmonary embolism after filter implantation did not occur in any patient. Of the 86 GTFs implanted, retrieval of 80 was attempted. Among those 80 filters, 77 (96%) were successfully retrieved (with the standard method, n = 72; with the modified method, n = 5) without any complication. The period of implantation of the retrieved filters was 13.4 +/- 4.2 days. In the 5 filters that were filled to a height of > or = 1/4 with trapped thrombus, retrieval was performed after attempts were made to decrease trapped thrombi. In addition, a temporary filter or another GTF was temporarily placed at the cephalad level of the GTF during this removal procedure.
GTFs can be retrieved in the majority of cases. Even when encountering situations in which the filter could not be removed using the standard method, withdrawal was possible in a high frequency of cases through various trials using modified methods.
评估取出Gunther郁金香可回收腔静脉滤器(GTF)的可行性和安全性。
2001年6月至2005年12月期间,在我们机构,86个GTF被植入59例患者(37名女性,22名男性;平均年龄59.3岁,范围18 - 87岁)体内用于临时腔静脉滤过。对于此后取出的GTF,我们回顾性分析了以下参数:取出成功率、滤器内血栓捕获程度以及取出过程中的并发症。
所有患者在滤器植入后均未出现肺栓塞加重或新发情况。在植入的86个GTF中,尝试取出80个。在这80个滤器中,77个(96%)成功取出(标准方法取出72个;改良方法取出5个),无任何并发症。取出的滤器植入时间为13.4±4.2天。在5个血栓捕获量达到或≥1/4高度填充的滤器中,在尝试减少血栓捕获量后进行取出。此外,在此取出过程中,在GTF头端水平临时放置了一个临时滤器或另一个GTF。
大多数情况下GTF可以取出。即使遇到无法使用标准方法取出滤器的情况,通过各种改良方法的尝试,在高比例病例中仍有可能取出。