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穿孔的下腔静脉滤器作为腹痛不明的原因。

Perforated inferior vena cava filters as the cause of unclear abdominal pain.

作者信息

Meyer Alexander, Schönleben Frank, Heinz Marco, Lang Werner

机构信息

Department of Vascular Surgery, University Hospital Erlangen, Erlangen, Germany.

出版信息

Ann Vasc Surg. 2013 Apr;27(3):354.e9-354.e12. doi: 10.1016/j.avsg.2012.08.006.

Abstract

Inferior vena cava filters are considered a valuable therapeutic option in patients with deep vein thrombosis, subsequent pulmonary emboli, and contraindication for anticoagulation. However, these filters bear the risk of rare but serious complications (e.g., symptomatic caval perforation). We report our experiences with retrievable vena cava filters by means of an actual case and review the recent literature with special regard to filter-dependent delayed symptomatic vena cava perforations. Here, an inferior vena cava filter could be identified as the source of a patient's abdominal pain; after an interventional retrieval approach had failed, open surgical removal became necessary and led to the instant relief of this patient's symptoms. Retrievable vena cava filter removal should be performed in all cases as soon as no longer needed to avoid fatal complications.

摘要

下腔静脉滤器被认为是深静脉血栓形成、继发肺栓塞以及抗凝治疗禁忌患者的一种有价值的治疗选择。然而,这些滤器存在罕见但严重并发症的风险(如症状性腔静脉穿孔)。我们通过一个实际病例报告了可回收下腔静脉滤器的经验,并特别针对与滤器相关的延迟性症状性腔静脉穿孔回顾了近期文献。在此,下腔静脉滤器可被确定为患者腹痛的根源;在介入性取出方法失败后,有必要进行开放性手术取出,这立即缓解了该患者的症状。一旦不再需要,应在所有情况下尽快取出可回收下腔静脉滤器,以避免致命并发症。

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