Department of Radiology, Division of Interventional Radiology, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.
J Vasc Interv Radiol. 2011 Jan;22(1):70-4. doi: 10.1016/j.jvir.2010.09.021. Epub 2010 Nov 24.
To examine the feasibility and safety of removing retrievable inferior vena cava (IVC) filters with struts external to the IVC wall on computed tomography (CT) imaging.
This retrospective study included 64 IVC filter retrievals from 62 patients over a 5-year period. CT images obtained before retrieval were used to describe the various imaging characteristics of filter interactions with the IVC wall. Patient medical records were reviewed for filter type, results of filter removal with standard or nonstandard techniques, and complications.
Filter struts outside the IVC wall were a common finding on CT with 55 (85.9%) filters showing some degree of perforation. Of 64 filters, 57 (89.1%) were removed successfully; 7 (10.9%) filters could not be removed because of incorporation of filter struts or tip into the IVC wall. Before retrieval, filter fracture was detected in eight (12.5%) cases, and IVC stenosis was present in three (4.7%) cases. No major complications occurred during any retrieval. Two (3.1%) cases were complicated by postprocedure abdominal pain. Both cases clinically resolved, and no abnormalities were detected on postprocedure CT.
The appearance of filter struts tenting or penetrating the IVC wall is a common finding on CT performed before filter retrieval. IVC filters with these findings can be removed safely and should not be a contraindication for IVC filter retrieval.
探讨在 CT 影像下取出体外下腔静脉(IVC)滤器支架的可行性和安全性。
本回顾性研究纳入了 62 例患者的 64 例 IVC 滤器取出术,研究时间为 5 年。使用 CT 图像描述滤器与 IVC 壁相互作用的各种影像学特征。回顾患者病历,记录滤器类型、标准或非标准技术取出滤器的结果以及并发症。
CT 显示 55 例(85.9%)滤器存在不同程度的支架穿出 IVC 壁,这是一种常见的发现。在 64 例滤器中,57 例(89.1%)成功取出;7 例(10.9%)因滤器支架或尖端与 IVC 壁融合而无法取出。在取出前,有 8 例(12.5%)发现滤器断裂,3 例(4.7%)存在 IVC 狭窄。任何取出过程中均未发生严重并发症。2 例(3.1%)出现术后腹痛,均经临床缓解,且术后 CT 未发现异常。
在 IVC 滤器取出前的 CT 检查中,滤器支架向外突出或穿透 IVC 壁是一种常见的表现。对于存在这些表现的 IVC 滤器,可以安全取出,不应成为 IVC 滤器取出的禁忌症。