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[下腔静脉滤器:还有任何适应证吗?]

[Inferior vena cava filters: any indications anymore?].

作者信息

Santoro Gennaro, Innocenti Daniela, Meucci Francesco, Squillantini Giovanni, Agostini Cecilia, Rosso Gabriele

机构信息

Dipartimento del Cuore e dei Vasi, Azienda Ospedaliero-Universitaria Careggi, Firenze.

出版信息

G Ital Cardiol (Rome). 2011 Sep;12(9):566-76. doi: 10.1714/926.10170.

Abstract

Inferior vena cava filters (IVCFs) are metal alloy devices that mechanically trap fragmented thromboemboli from the deep leg veins en route to the pulmonary circulation. Filters are introduced (and in the case of retrievable filters, removed) percutaneously. Although their deployment seems of theoretical benefit, their clinical efficacy and adverse event profile are unclear because there are very few controlled and randomized data. IVCFs are most frequently used in patients with contraindications to anticoagulation and in anticoagulated patients with recurrent pulmonary embolism, but few data are available in the literature about their efficacy. The indications for filters are based largely on custom, historical practice patterns and physician preferences, and their use is increasing: more trials are needed to confirm their benefit and accurately assess their safety. The care of patients with or at risk of venous thromboembolism is as variable and challenging as the range of patients who suffer from venous thrombosis. Careful, individualized decision regarding IVCF placement will be required for many years as we strive to learn more about these devices.

摘要

下腔静脉滤器(IVCFs)是金属合金装置,可机械性捕获来自下肢深静脉、在进入肺循环途中的破碎血栓栓子。滤器通过经皮方式置入(对于可回收滤器,则进行取出操作)。尽管其应用从理论上看似乎有益,但由于对照和随机数据非常少,其临床疗效和不良事件情况尚不清楚。IVCFs最常用于有抗凝禁忌证的患者以及抗凝治疗过程中发生复发性肺栓塞的患者,但文献中关于其疗效的数据很少。滤器的适应证很大程度上基于惯例、既往实践模式和医生偏好,并且其使用正在增加:需要更多试验来证实其益处并准确评估其安全性。静脉血栓栓塞患者或有静脉血栓栓塞风险患者的护理,与患有静脉血栓形成的患者群体一样多变且具有挑战性。在我们努力更多地了解这些装置的许多年里,对于IVCF置入需要进行谨慎、个体化的决策。

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