Stavropoulos S William, Dixon Robert G, Burke Charles T, Stavas Joseph M, Shah Anand, Shlansky-Goldberg Richard D, Trerotola Scott O
Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, 1 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104, USA.
J Vasc Interv Radiol. 2008 Sep;19(9):1297-301. doi: 10.1016/j.jvir.2008.04.012. Epub 2008 Jun 2.
Removing a retrievable inferior vena cava (IVC) filter can be extremely difficult with the use of standard techniques if the filter is tilted and embedded in the wall of the IVC. The use of rigid endobronchial forceps has been described in case reports to remove embedded IVC filters, and the present report describes the use of this technique to remove a series of tip-embedded IVC filters in two separate institutions.
The medical records were reviewed of 21 consecutive patients at two institutions who underwent attempted IVC filter removal with rigid endobronchial forceps over a 34-month period. The mean age of patients was 32.4 years (range, 14.1-54.1 y). The patients had the following filters: Recovery (n = 6), G2 (n = 10), Günther Tulip (n = 4), and OptEase (n = 1).
Rotational or biplane venography was used to confirm that the filters were tilted and embedded in the wall of the IVC in all 21 patients. Rigid endobronchial forceps were used successfully to remove 20 embedded IVC filters in 21 patients. There was one case of failure to remove an embedded suprarenal G2 filter. There were no major complications.
Rigid endobronchial forceps may be used as a reliable option for removal of embedded IVC filters.
如果可回收下腔静脉（IVC）滤器发生倾斜并嵌入下腔静脉壁，使用标准技术将其取出可能极其困难。病例报告中曾描述使用硬质支气管钳取出嵌入的IVC滤器，本报告介绍了在两家不同机构使用该技术取出一系列尖端嵌入的IVC滤器的情况。
回顾了两家机构连续21例患者的病历，这些患者在34个月的时间里尝试使用硬质支气管钳取出IVC滤器。患者的平均年龄为32.4岁（范围14.1 - 54.1岁）。患者使用的滤器如下：Recovery（n = 6）、G2（n = 10）、Günther Tulip（n = 4）和OptEase（n = 1）。
在所有21例患者中，均通过旋转或双平面静脉造影确认滤器倾斜并嵌入下腔静脉壁。在21例患者中，成功使用硬质支气管钳取出了20个嵌入的IVC滤器。有1例未能取出嵌入的肾上G2滤器。未发生重大并发症。
硬质支气管钳可作为取出嵌入IVC滤器的可靠选择。
