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与 Günther Tulip 下腔静脉滤器取出失败相关的因素。

Factors associated with failed retrieval of the Günther Tulip inferior vena cava filter.

作者信息

Marquess Joel S, Burke Charles T, Beecham Ashley H, Dixon Robert G, Stavas Joseph M, Sag Alan A, Koch Gary G, Mauro Matthew A

机构信息

Department of Radiology, University of North Carolina, Chapel Hill, North Carolina 27599-7510, USA.

出版信息

J Vasc Interv Radiol. 2008 Sep;19(9):1321-7. doi: 10.1016/j.jvir.2008.06.004. Epub 2008 Jul 21.

Abstract

PURPOSE

To identify potential factors associated with failed retrieval of the Günther Tulip inferior vena cava (IVC) filter.

MATERIALS AND METHODS

A retrospective review was performed of patients who underwent placement of the Günther Tulip filter with at least one attempt at filter retrieval over a 3-year period. Patient demographics, filter dwell time, filter angulation, and filter leg protrusion were analyzed.

RESULTS

A total of 188 patients were included in the study. Primary retrieval success was achieved in 166 patients (88.3%), for an overall retrieval success rate of 94.2%. The overall mean dwell time was 63 days, whereas the mean dwell time in cases of retrieval failure was 95.4 days. A total of seven filters were in place for longer than 6 months, four of which were successfully retrieved. The degree of filter tilt was not found to be significantly related to retrieval success (P = .36), even though filter angulation was commonly cited as a reason for retrieval failure. On venography, 90.9% of filters that could not be retrieved showed leg protrusion beyond the lumen of the IVC. Finally, increasing patient age also correlated with retrieval failure (P = .01).

CONCLUSIONS

Prolonged dwell time and increasing patient age are associated with failed filter retrieval. However, even filters in place for extended periods can be safely removed.

摘要

目的

确定与 Günther Tulip 下腔静脉(IVC)滤器取出失败相关的潜在因素。

材料与方法

对在 3 年期间接受 Günther Tulip 滤器置入且至少尝试过一次滤器取出的患者进行回顾性研究。分析患者人口统计学资料、滤器留置时间、滤器角度和滤器腿突出情况。

结果

本研究共纳入 188 例患者。166 例患者(88.3%)首次取出成功,总体取出成功率为 94.2%。总体平均留置时间为 63 天,而取出失败病例的平均留置时间为 95.4 天。共有 7 个滤器留置时间超过 6 个月,其中 4 个成功取出。尽管滤器角度常被认为是取出失败的原因,但未发现滤器倾斜程度与取出成功有显著相关性(P = 0.36)。在静脉造影中,90.9%无法取出的滤器显示滤器腿突出至下腔静脉管腔外。最后,患者年龄增加也与取出失败相关(P = 0.01)。

结论

留置时间延长和患者年龄增加与滤器取出失败相关。然而,即使是长期留置的滤器也可安全取出。

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