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一种可回收下腔静脉滤器患者的随访方法:1100 例患者的结果和经验教训。

A method for following patients with retrievable inferior vena cava filters: results and lessons learned from the first 1,100 patients.

机构信息

Departments of Radiology, Surgery and Medicine, The Penn State Heart and Vascular Institute, Milton S. Hershey Medical Center, Penn State University College of Medicine, Hershey, PA 17033, USA.

出版信息

J Vasc Interv Radiol. 2011 Nov;22(11):1507-12. doi: 10.1016/j.jvir.2011.07.019. Epub 2011 Sep 8.

Abstract

PURPOSE

Patients who have undergone implantation of a retrievable inferior vena cava (IVC) filter require continued follow-up to have the device removed when clinically appropriate and in a timely fashion to avoid potential long-term filter-related complications. The efficacy of a method for patient follow-up was evaluated based on a retrospective review of a single-institutional retrievable IVC filter experience.

MATERIALS AND METHODS

Patients with retrievable IVC filters were tracked via a prospectively collected database designed specifically for patient follow-up. Follow-up consisted of periodic review of the electronic medical record. Patients were contacted by mail (at regular intervals one or more times) when removal of the filter was deemed appropriate. A retrospective review of the ultimate fate of the first 1,127 retrievable IVC filters placed at a single institution was performed. Retrieval rates were compared with those seen in the initial experience, during which no structured follow-up was performed.

RESULTS

Of 1,127 filters placed, 658 (58.4%) were removed. Filter removal or declaration of the device as permanent was achieved in 860 patients (76.3%). Filter removal, declaration of the device as permanent, or establishment of the need for continued follow-up was achieved in 941 patients (83.5%). Only 186 patients (16.5%) were lost to follow-up.

CONCLUSIONS

The follow-up method described in the present study resulted in a statistically significant difference (P < .001) in the likelihood of a patient returning for IVC filter removal compared with a lack of follow-up (59% vs 24%).

摘要

目的

接受可回收下腔静脉(IVC)滤器植入的患者需要持续随访,以便在临床适当且及时的情况下将装置取出,以避免潜在的长期滤器相关并发症。本研究通过回顾性分析单中心可回收 IVC 滤器经验,评估了一种患者随访方法的效果。

材料和方法

通过专门设计用于患者随访的前瞻性收集数据库对具有可回收 IVC 滤器的患者进行跟踪。随访包括定期电子病历复查。当认为需要取出滤器时,通过邮件(定期多次)与患者联系。对一家单机构放置的前 1127 个可回收 IVC 滤器的最终结局进行回顾性分析。与初始经验(未进行结构化随访)相比,比较了回收率。

结果

共放置 1127 个滤器,其中 658 个(58.4%)被取出。860 例(76.3%)患者实现了滤器取出或永久性植入物的宣告。941 例(83.5%)患者实现了滤器取出、永久性植入物的宣告或继续随访的确定。仅有 186 例(16.5%)患者失访。

结论

与缺乏随访相比(59%比 24%),本研究中描述的随访方法显著提高了患者返回接受 IVC 滤器取出的可能性(P<0.001)。

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