Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio 44195, USA.
J Vasc Interv Radiol. 2012 Dec;23(12):1557-63. doi: 10.1016/j.jvir.2012.08.016.
To evaluate retrospectively the safety and retrievability of the Celect IVC filter.
All patients undergoing Celect filter placement and retrieval during the period 2007-2012 were assessed for complications and retrievability.
Of 620 patients who underwent Celect filter placement, 120 presented for removal. The indwelling time in these patients was 158.1 days±103.0 (range, 2-518 d). There were 106 filters (88.3%) removed; 14 filters were left in situ for the following reasons: filter embedment (n=6), caval occlusion (n=3), retained thrombus (n=2), large floating thrombus in IVC (n=2), or tilt >15° (n=1). With filters in place, five patients developed new pulmonary embolism (PE), and two others presented with severe abdominal pain. The available 115 pairs of placement and removal cavagrams suggested limb penetration in 99 cases (86.1%), intracaval migration >2 cm in 5, secondary tilt >15° in 8, filter deformity in 10, retained thrombus within filters in 12, and IVC occlusion in 3. Among 38 available computed tomography (CT) scans, 9 scans (24%) showed asymptomatic limb penetration to the duodenum (n=6), aortic wall (n=2), or kidney (n=1). No filter fracture was found.
This study showed a high penetration rate for Celect IVC filters, including penetrations that were symptomatic or involved adjacent structures. Penetration appears to correlate with indwelling time, suggesting that the filter should be removed as soon as PE protection is no longer indicated. Although most of the filters were removed, 5.8% of retrievals were unsuccessful because of technical failure.
回顾性评估 Celect IVC 滤器的安全性和可回收性。
评估 2007 年至 2012 年期间行 Celect 滤器置入和取出术的所有患者的并发症和可回收性。
在 620 例行 Celect 滤器置入的患者中,有 120 例患者因滤器取出而就诊。这些患者的留置时间为 158.1 天±103.0(范围,2-518 天)。有 106 个(88.3%)滤器被取出;14 个滤器仍留置原位,原因如下:滤器嵌入(n=6)、腔静脉阻塞(n=3)、保留血栓(n=2)、IVC 内较大漂浮血栓(n=2)或倾斜度>15°(n=1)。滤器在位时,5 例患者新发肺栓塞(PE),另有 2 例患者出现严重腹痛。115 对置放和取出腔静脉造影提示 99 例(86.1%)存在支腿穿透,5 例存在腔内迁移>2cm,8 例存在继发性倾斜度>15°,10 例存在滤器变形,12 例存在滤器内保留血栓,3 例存在 IVC 阻塞。38 例可获得 CT 扫描中,9 例(24%)扫描显示无症状支腿穿透至十二指肠(n=6)、主动脉壁(n=2)或肾脏(n=1)。未发现滤器断裂。
本研究显示 Celect IVC 滤器的穿透率较高,包括穿透症状或涉及相邻结构的滤器。穿透似乎与留置时间相关,提示一旦不再需要 PE 保护,就应取出滤器。尽管大多数滤器被取出,但由于技术失败,5.8%的取出术未能成功。