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提高下腔静脉滤器取出率:专门的下腔静脉滤器门诊的影响。

Improving inferior vena cava filter retrieval rates: impact of a dedicated inferior vena cava filter clinic.

机构信息

Department of Radiology, Northwestern University, Chicago, IL 60611, USA.

出版信息

J Vasc Interv Radiol. 2010 Dec;21(12):1847-51. doi: 10.1016/j.jvir.2010.09.003. Epub 2010 Oct 28.

Abstract

PURPOSE

To test the hypothesis that an inferior vena cava (IVC) filter clinic increases the retrieval rate of optional IVC filters.

MATERIALS AND METHODS

Patients who had optional IVC filters placed at the authors' institution between January 2000 and December 2008 were identified and retrospectively studied. A dedicated IVC filter clinic was established at this institution in January 2009, and there is a comprehensive database of prospectively acquired data for patients seen in the IVC filter clinic. Patients were chronologically classified into preclinic and postclinic groups. The number of optional filters retrieved and failed retrieval attempts were recorded.

RESULTS

In the preclinic and postclinic periods, 369 and 100 optional IVC filters were placed. Median (interquartile range) number of optional filters placed per month for preclinic and postclinic periods was 3 (range 2-5) and 10 (range 6.5-10.5) (P < .001). Retrieval rates in preclinic and postclinic periods were 108 of 369 (29%) and 60 of 100 (60%) (P < .001). The median time to filter retrieval in the postclinic group was 1.5 months (95% confidence interval 1.2-1.8). The number of failed retrieval attempts in preclinic and postclinic periods was 23 of 369 (6%) and 5 of 100 (5%) (P = .823).

CONCLUSIONS

The retrieval rate of optional IVC filters at this institution was significantly increased by the establishment of a dedicated IVC filter clinic. This retrieval increase is not related to a decrease in technical failures but more likely relates to more meticulous patient management and clinical follow-up.

摘要

目的

检验下腔静脉滤器(IVC)门诊是否会提高可回收 IVC 滤器的回收率这一假设。

材料和方法

回顾性分析了 2000 年 1 月至 2008 年 12 月期间在本机构植入可回收 IVC 滤器的患者。2009 年 1 月,本机构成立了一个专门的 IVC 滤器门诊,建立了一个前瞻性采集 IVC 滤器门诊患者数据的综合数据库。患者按照时间顺序分为门诊前和门诊后两组。记录可回收滤器的数量和未回收尝试次数。

结果

在门诊前和门诊后时期,分别植入了 369 个和 100 个可回收 IVC 滤器。门诊前和门诊后时期每月植入可回收滤器的中位数(四分位距)分别为 3 个(范围 2-5)和 10 个(范围 6.5-10.5)(P<0.001)。门诊前和门诊后时期的回收成功率分别为 369 个中的 108 个(29%)和 100 个中的 60 个(60%)(P<0.001)。门诊后组的滤器中位回收时间为 1.5 个月(95%置信区间 1.2-1.8)。门诊前和门诊后时期的未回收尝试次数分别为 369 个中的 23 个(6%)和 100 个中的 5 个(5%)(P=0.823)。

结论

本机构专门的 IVC 滤器门诊的建立显著提高了可回收 IVC 滤器的回收率。这种回收率的提高与技术失败的减少无关,更可能与更细致的患者管理和临床随访有关。

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