Murphy T P, Dorfman G S, Yedlicka J W, McCowan T C, Vogelzang R L, Hunter D W, Carver D K, Pinsk R, Castaneda-Zuniga W, Ferris E J
Department of Diagnostic Imaging, Rhode Island Hospital, Providence 02903.
J Vasc Interv Radiol. 1991 Feb;2(1):107-15. doi: 10.1016/s1051-0443(91)72482-2.
One hundred one LG-Medical (LGM) vena cava filters were placed in 97 patients at four institutions. Placement was a complete technical success in 90% (91 of 101). In 6% of attempts, LGM filter insertion was complicated by incomplete opening of the filter. Pulmonary embolism after filter placement was not definitely demonstrated in any patient. The probability of inferior vena cava patency was 92% at 6 months after filter insertion. Thrombosis at the insertion site was seen in eight of 35 patients (23%) evaluated with duplex ultrasound or venography. Thrombus was observed in 37% of filters at follow-up examination, with cephalic extension of thrombus above the filter in 20% of all patients examined. Filter migration (greater than 1 cm) was seen in 12%; significant angulation was observed in only one patient (2%). In vitro experimentation demonstrated that incomplete opening of the LGM filter during placement can be avoided, in part, by brisk retraction of the insertion cannula. The low-profile introducer system of the LGM filter allows increased alternatives in selecting the site for filter insertion. The low-profile system also makes outpatient filter placement a possibility. No significant difference in the prevalence of thrombosis at the insertion site following LGM filter insertion was noted compared with previous results reported for percutaneous transfemoral placement of the Greenfield filter. The nonopaque sheath does not permit careful localization prior to filter deposition. Modification of the LGM filter to include a radiopaque sheath is suggested.
在四家机构的97名患者中放置了101个LG医疗（LGM）腔静脉滤器。90%（101个中的91个）的放置在技术上完全成功。在6%的尝试中，LGM滤器插入因滤器未完全打开而复杂化。滤器放置后没有任何患者明确显示发生肺栓塞。滤器插入后6个月时，下腔静脉通畅的概率为92%。在接受双功超声或静脉造影评估的35名患者中，有8名（23%）在插入部位出现血栓形成。在随访检查中，37%的滤器观察到血栓，在所有接受检查的患者中，20%的血栓向滤器上方的头侧延伸。滤器移位（大于1厘米）见于12%；仅1名患者（2%）观察到明显成角。体外实验表明，放置过程中LGM滤器未完全打开可部分通过快速回撤插入套管来避免。LGM滤器的低轮廓导入系统增加了选择滤器插入部位的可能性。低轮廓系统也使门诊放置滤器成为可能。与先前报道的经皮股静脉放置格林菲尔德滤器的结果相比，LGM滤器插入后插入部位血栓形成的发生率没有显著差异。不透明的鞘管在滤器放置前不允许精确定位。建议对LGM滤器进行改进，使其包括一个不透射线的鞘管。
