Sangwaiya Minal Jagtiani, Marentis Theodore C, Walker T Gregory, Stecker Michael, Wicky Stephan T, Kalva Sanjeeva P
Department of Radiology, Massachusetts General Hospital, USA.
J Vasc Interv Radiol. 2009 Sep;20(9):1188-92. doi: 10.1016/j.jvir.2009.05.033. Epub 2009 Jul 23.
To evaluate the safety and effectiveness of the Celect inferior vena cava (IVC) filter during implantation, retrieval, and short-term follow-up.
The clinical data of 73 patients (46 men; age range, 22-89 years) who had a Celect IVC filter implanted between August 2007 and June 2008 were reviewed. Twenty-one (28.8%) presented with pulmonary embolism (PE), 15 (20.54%) with deep vein thrombosis (DVT), 12 (16.4%) with both, and the rest (34.26%) with other symptoms. Indications for filter placement were contraindication to anticoagulation (n = 38; 52%), prophylaxis/added protection (n = 22; 30%), failure of anticoagulation (n = 11; 15%), and complications of anticoagulation (n = 2; 3%). Filters were placed in the infrarenal (n = 71) or suprarenal (n = 2) IVC. Follow-up data were reviewed for filter-related complications and recurrent PE.
All filters were successfully deployed. Immediately after fluoroscopy-guided filter deployment in 61 patients, four filters (6.5%) showed significant tilt. During follow-up (mean, 68 days +/- 73), three patients developed symptoms of PE after filter placement; however, computed tomographic (CT) pulmonary angiography demonstrated new PE in only two. Imaging follow-up with radiography (n = 32), CT (n = 11), and/or angiography (n = 4) in 47 patients (at a mean of 62 days +/- 75) showed no filter migration. Follow-up abdominal CT (at a mean of 69 days +/- 58) was available in 18 patients and demonstrated filter-related problems in seven (39%). These included penetration of filter legs in four and fracture/migration of filter components in one. Fourteen filters were successfully retrieved after a median period of 84 days.
The Celect IVC filter can be safely placed but is related to a high incidence of caval filter leg penetration. Symptomatic PE after filter placement confirmed by CT occurred in 2.8% of patients.
评估Celect下腔静脉(IVC)滤器在植入、取出及短期随访期间的安全性和有效性。
回顾了2007年8月至2008年6月间植入Celect IVC滤器的73例患者(46例男性;年龄范围22 - 89岁)的临床资料。21例(28.8%)表现为肺栓塞(PE),15例(20.54%)表现为深静脉血栓形成(DVT),12例(16.4%)两者皆有,其余(34.26%)有其他症状。滤器置入的指征为抗凝禁忌(n = 38;52%)、预防/额外保护(n = 22;30%)、抗凝失败(n = 11;15%)以及抗凝并发症(n = 2;3%)。滤器置于肾下(n = 71)或肾上(n = 2)下腔静脉。回顾随访数据以了解与滤器相关的并发症及复发性PE情况。
所有滤器均成功置入。在61例患者经透视引导滤器置入后即刻,4个滤器(6.5%)出现明显倾斜。在随访期间(平均68天±73天),3例患者在滤器置入后出现PE症状;然而,计算机断层扫描(CT)肺血管造影仅在2例中显示有新发PE。47例患者(平均62天±75天)接受了X线摄影(n = 32)、CT(n = 11)和/或血管造影(n = 4)的影像学随访,未发现滤器移位。18例患者进行了随访腹部CT(平均69天±58天),7例(39%)显示有与滤器相关的问题。其中包括4例滤器腿穿透和1例滤器部件骨折/移位。14个滤器在中位时间84天后成功取出。
Celect IVC滤器可安全置入,但与较高的腔静脉滤器腿穿透发生率相关。经CT证实滤器置入后有症状的PE在2.8%的患者中出现。