Goei Anthony D, Josephs Shellie C, Kinney Thomas B, Ray Charles E, Sacks David
Semin Intervent Radiol. 2011 Mar;28(1):118-27. doi: 10.1055/s-0031-1273946.
Therapeutic and prophylactic inferior vena cava (IVC) filters should be placed based on currently accepted indications to prevent a fatal pulmonary embolism (PE). The protective effect of filters is offset by the potential for lower extremity deep venous thrombosis (DVT), caval thrombosis, and possible otherwise unnecessary life-long anticoagulation (AC). The duration of treatment for most DVTs or PEs is 3 to 6 months of AC/filter. Filters should be retrieved when duration of treatment for a DVT/PE has been met, the risk of a PE is no longer high, and/or there is no longer a contraindication to AC. An effective system that leads to improving the retrieval rate of filters must include education of the patient, a tracking system to minimize patient lost to follow-up, and dedicated personnel to oversee the process. If these goals are accomplished, interventionalists can help decrease the incidence of a fatal PE during the high-risk period, and also decrease the risk of a DVT or the use of otherwise unnecessary life-long AC in subsequent years. Currently, there is much room for improvement in the frequency that IVCF patients are systematically followed and filters are retrieved. The principles discussed in this report will be helpful in this process.
治疗性和预防性下腔静脉（IVC）滤器应根据目前公认的适应症放置，以预防致命性肺栓塞（PE）。滤器的保护作用被下肢深静脉血栓形成（DVT）、腔静脉血栓形成以及可能不必要的终身抗凝（AC）的可能性所抵消。大多数DVT或PE的治疗持续时间为3至6个月的AC/滤器治疗。当满足DVT/PE的治疗持续时间、PE风险不再高和/或不再有AC禁忌证时，应取出滤器。一个能提高滤器取出率的有效系统必须包括对患者的教育、一个尽量减少患者失访的跟踪系统以及专门人员监督该过程。如果实现了这些目标介入专家可以帮助降低高危期致命性PE的发生率，并降低随后几年DVT的风险或不必要的终身AC的使用。目前，IVCF患者得到系统随访和滤器取出的频率有很大的改进空间。本报告中讨论 的原则将有助于这一过程。
