Department of Internal Medicine and Research and Advanced Studies Program, College of Osteopathic Medicine, Michigan State University, East Lansing, USA.
Am J Med. 2011 Jul;124(7):655-61. doi: 10.1016/j.amjmed.2011.02.021. Epub 2011 May 17.
To test whether the use of vena cava filters continues to increase in the era of retrievable filters, suggesting that indications for insertion are broadening.
Data from 1979 through 2006 are from the National Hospital Discharge Survey.
From 1979 through 1984, 17,000 vena cava filters were inserted; 8000 in patients with pulmonary embolism, 4000 in patients with deep venous thrombosis only, and 5000 in patients at risk of pulmonary embolism who had neither. From 1985 through 2006, 803,000 vena cava filters were inserted: 285,000 in patients with pulmonary embolism, 360,000 in patients with deep venous thrombosis only, and 158,000 in patients who had neither. The largest proportional increases in the use of vena cava filters since the introduction of retrievable filters was in patients at risk of pulmonary embolism but who had neither pulmonary embolism nor deep venous thrombosis. The trend toward increased use in this group began before retrievable filters were introduced. There was a 3-fold increase from 2001-2006.
Extensive use of permanent and retrievable vena cava filters in the US indicates liberalization of indications. It would seem that a more discriminate use of vena cava filters would be appropriate at the present time, keeping an open mind for broadened indications as data accrue.
检测可回收滤器时代下，腔静脉滤器的使用是否持续增加，是否提示适应证在扩大。
数据来源于 1979 年至 2006 年的全国住院患者抽样调查。
1979 年至 1984 年，共植入 17000 个腔静脉滤器；其中 8000 个用于治疗肺栓塞，4000 个用于治疗单纯深静脉血栓，5000 个用于预防肺栓塞的高危患者。1985 年至 2006 年，共植入 803000 个腔静脉滤器；其中 285000 个用于治疗肺栓塞，360000 个用于治疗单纯深静脉血栓，158000 个用于预防肺栓塞的高危患者。自可回收滤器问世以来，腔静脉滤器使用率最大的增长出现在那些有肺栓塞风险但既无肺栓塞又无深静脉血栓的患者中。该趋势在可回收滤器问世前就已经出现，并在 2001-2006 年间增长了 3 倍。
在美国，永久性和可回收腔静脉滤器的广泛应用表明适应证放宽。目前，考虑到数据的积累，对腔静脉滤器的使用进行更具辨别力的评估似乎是恰当的，同时对适应证的拓宽持开放态度。
