Department of Radiology, The First Hospital of China Medical University, Shenyang 110001, China.
Korean J Radiol. 2012 Jul-Aug;13(4):483-91. doi: 10.3348/kjr.2012.13.4.483. Epub 2012 Jun 18.
To determine whether the introducer curving technique is useful in decreasing the degree of tilting of transfemoral Tulip filters.
The study sample group consisted of 108 patients with deep vein thrombosis who were enrolled and planned to undergo thrombolysis, and who accepted transfemoral Tulip filter insertion procedure. The patients were randomly divided into Group C and Group T. The introducer curving technique was Adopted in Group T. The post-implantation filter tilting angle (ACF) was measured in an anteroposterior projection. The retrieval hook adhering to the vascular wall was measured via tangential cavogram during retrieval.
The overall average ACF was 5.8 ± 4.14 degrees. In Group C, the average ACF was 7.1 ± 4.52 degrees. In Group T, the average ACF was 4.4 ± 3.20 degrees. The groups displayed a statistically significant difference (t = 3.573, p = 0.001) in ACF. Additionally, the difference of ACF between the left and right approaches turned out to be statistically significant (7.1 ± 4.59 vs. 5.1 ± 3.82, t = 2.301, p = 0.023). The proportion of severe tilt (ACF ≥ 10°) in Group T was significantly lower than that in Group C (9.3% vs. 24.1%, χ(2) = 4.267, p = 0.039). Between the groups, the difference in the rate of the retrieval hook adhering to the vascular wall was also statistically significant (2.9% vs. 24.2%, χ(2) = 5.030, p = 0.025).
The introducer curving technique appears to minimize the incidence and extent of transfemoral Tulip filter tilting.
探讨采用导引导管弯曲技术是否可以降低经股动脉置入 Tulip 滤器的倾斜角度。
本研究纳入并计划行经股动脉 Tulip 滤器置入术的 108 例下肢深静脉血栓患者作为研究样本。将患者随机分为 C 组和 T 组，T 组采用导引导管弯曲技术，在正位片上测量滤器置入后的滤器倾斜角度（ACF），在取栓时测量沿切线方向的血管壁附着的取栓钩。
整体平均 ACF 为 5.8±4.14°。C 组平均 ACF 为 7.1±4.52°，T 组平均 ACF 为 4.4±3.20°。两组间 ACF 差异有统计学意义（t=3.573，p=0.001）。左、右侧 ACF 差异有统计学意义（7.1±4.59 vs. 5.1±3.82，t=2.301，p=0.023）。T 组严重倾斜（ACF≥10°）的比例明显低于 C 组（9.3% vs. 24.1%，χ(2)=4.267，p=0.039）。两组间取栓钩附着于血管壁的比例差异也有统计学意义（2.9% vs. 24.2%，χ(2)=5.030，p=0.025）。
导引导管弯曲技术可降低经股动脉 Tulip 滤器置入后的倾斜角度和发生率。
