Marquess Joel S, Burke Charles T, Beecham Ashley H, Dixon Robert G, Stavas Joseph M, Sag Alan A, Koch Gary G, Mauro Matthew A
Department of Radiology, University of North Carolina, Chapel Hill, North Carolina 27599-7510, USA.
J Vasc Interv Radiol. 2008 Sep;19(9):1321-7. doi: 10.1016/j.jvir.2008.06.004. Epub 2008 Jul 21.
To identify potential factors associated with failed retrieval of the Günther Tulip inferior vena cava (IVC) filter.
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.
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).
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.
确定与 Günther Tulip 下腔静脉(IVC)滤器取出失败相关的潜在因素。
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。
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)。
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。