Reed R A, Teitelbaum G P, Taylor F C, Vogelzang R C, Yedlicka J W, Pentecost M J, Castaneda-Zuniga W R, Amplatz K
Department of Radiology, LAC-USC Medical Center 90033.
J Vasc Interv Radiol. 1991 Nov;2(4):441-5. doi: 10.1016/s1051-0443(91)72215-x.
Over a 12-month period, 216 LGM vena caval filters were placed in 216 patients at four institutions. The transjugular approach was used in 31 of 216 insertions (14%); 185 of 216 filters (86%) were inserted via the femoral route. Incomplete opening of filters was encountered in 13 of 31 transjugular insertions (41%) and none of 185 transfemoral insertions. Delayed spontaneous filter opening occurred in three of 12 cases (25%) of incomplete opening (in which follow-up was available) at 5 minutes, 4 days, and 2 months after insertion. One filter opened completely after catheter manipulations. Several mechanisms explaining this complication are proposed. In its present form, the LGM filter should not be inserted via the jugular route. Since the filtering capabilities of the incompletely opened LGM device have been shown to be diminished in vitro, it may be advisable to place a second filter cephalad to an incompletely opened LGM filter.
在12个月的时间里，在四家机构为216例患者植入了216个LGM腔静脉滤器。216次植入中有31次（14%）采用经颈静脉途径；216个滤器中有185个（86%）经股静脉途径植入。31次经颈静脉植入中有13次（41%）出现滤器未完全打开的情况，而185次经股静脉植入均未出现这种情况。在12例（随访资料完整）滤器未完全打开的病例中，有3例（25%）在植入后5分钟、4天和2个月出现延迟性滤器自发打开。有一个滤器在导管操作后完全打开。文中提出了几种解释这一并发症的机制。以目前的形式，LGM滤器不应经颈静脉途径植入。由于体外研究表明未完全打开的LGM装置的过滤能力会降低，因此在未完全打开的LGM滤器头端再植入一个滤器可能是可取的。
