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可回收下腔静脉滤器的安全性和有效性:美国前瞻性多中心临床研究。

The safety and effectiveness of the retrievable option inferior vena cava filter: a United States prospective multicenter clinical study.

机构信息

Department of Radiology, Indiana University School of Medicine, 550 University Blvd, Indianapolis, IN 46202, USA.

出版信息

J Vasc Interv Radiol. 2010 Aug;21(8):1173-84. doi: 10.1016/j.jvir.2010.04.004. Epub 2010 Jul 3.

Abstract

PURPOSE

To evaluate the safety and effectiveness of the retrievable Option inferior vena cava (IVC) filter in patients at risk for pulmonary embolism (PE).

MATERIALS AND METHODS

This was a prospective, multicenter, single-arm clinical trial. Subjects (N = 100) underwent implantation of the IVC filter and were followed for 180 days; subjects whose filters were later removed were followed for 30 days thereafter. The primary objective was to determine whether the one-sided lower limit of the 95% CI for the observed clinical success rate was at least 80%. Clinical success was defined as technical success (deployment of the filter such that it was judged suitable for mechanical protection from PE) without subsequent PE, significant filter migration or embolization, symptomatic caval thrombosis, or other complications.

RESULTS

Technical success was achieved in 100% of subjects. There were eight cases of recurrent PE, two cases of filter migration (23 mm), and three cases of symptomatic caval occlusion/thrombosis (one in a subject who also experienced filter migration). No filter embolization or fracture occurred. Clinical success was achieved in 88% of subjects; the one-sided lower limit of the 95% CI was 81%. Retrieval was successful at a mean of 67.1 days after implantation (range, 1-175 d) for 36 of 39 subjects (92.3%). All deaths (n = 17) and deep vein thromboses (n = 18) were judged to have resulted from preexisting or intercurrent illnesses or interventions and unrelated to the filter device; all deaths were judged to be unrelated to PE.

CONCLUSIONS

Placement and retrieval of the Option IVC filter were performed safely and with high rates of clinical success.

摘要

目的

评估可回收 Option 下腔静脉(IVC)滤器在有发生肺栓塞(PE)风险的患者中的安全性和有效性。

材料和方法

这是一项前瞻性、多中心、单臂临床研究。受试者(N=100)接受 IVC 滤器植入,并随访 180 天;随后取出滤器的受试者在之后的 30 天内进行随访。主要目的是确定观察到的临床成功率的 95%CI 的单侧下限是否至少为 80%。临床成功定义为技术成功(滤器的部署使其被判断适合机械保护免受 PE),且没有随后发生 PE、显著的滤器迁移或栓塞、症状性腔静脉血栓形成或其他并发症。

结果

技术成功率为 100%。有 8 例复发性 PE、2 例滤器迁移(23mm)和 3 例症状性腔静脉闭塞/血栓形成(1 例患者同时经历滤器迁移)。没有滤器栓塞或断裂发生。88%的受试者达到了临床成功;95%CI 的单侧下限为 81%。39 例受试者中有 36 例(92.3%)在植入后平均 67.1 天(范围 1-175 天)成功取出滤器。所有死亡(n=17)和深静脉血栓形成(n=18)均被认为是由既往或并发疾病或干预引起的,与滤器装置无关;所有死亡均被认为与 PE 无关。

结论

放置和取出 Option IVC 滤器是安全的,且具有较高的临床成功率。

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