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肾静脉异常患者下腔静脉滤器置入的临床结局

Clinical outcomes of inferior vena cava filter placement in patients with renal vein anomalies.

作者信息

Fang Adam S, Morita Satoru, Gill Gunvir S, Kitanosono Takashi, Mathes Edward J, Lee David E, Waldman David L

机构信息

Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY.

Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY; Department of Diagnostic Imaging and Nuclear Medicine (Radiology), Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Ann Vasc Surg. 2014 Feb;28(2):318-23. doi: 10.1016/j.avsg.2013.01.026. Epub 2013 Sep 29.

Abstract

BACKGROUND

To investigate the clinical outcomes in patients with renal vein anomalies who undergo inferior vena cava (IVC) filter placement.

METHODS

Contrast-enhanced computed tomography images of 410 patients who underwent IVC filter placement were retrospectively reviewed to detect renal vein anomalies. Clinical outcomes involving de novo pulmonary embolism and worsening of renal function were compared between patients with the location of filters placed in relation to the anomalous renal veins versus not in relation to any renal veins.

RESULTS

A total of 97 (23.7%) renal vein anomalies were identified: 62 (15.1%) multiple right renal veins, 23 (5.6%) circumaortic left renal veins, 10 (2.4%) retroaortic left renal veins, and 2 (0.5%) accessory left renal veins. Frequency of de novo pulmonary embolism in patients with circumaortic left renal veins who had filters placed at or in between the 2 left renal veins was not significantly different from patients who underwent infra- or suprarenal filter placement (5.9% [1/17] vs. 3.1% [12/387]; P = 0.433). The frequency of patients who had a >25% decrease in estimated glomerular filtration rate after IVC filter placement was not significantly different whether the filter was placed in an infrarenal location or at or above the level of the anomalous renal veins (11.0% [37/335] vs. 17.6% [6/34]; P = 0.261).

CONCLUSIONS

Clinical outcomes involving the frequency of de novo pulmonary embolism and worsening of renal function are not dependent on location of IVC filter placement in patients with renal vein anomalies.

摘要

背景

探讨接受下腔静脉(IVC)滤器置入术的肾静脉异常患者的临床结局。

方法

回顾性分析410例行IVC滤器置入术患者的增强CT图像,以检测肾静脉异常情况。比较滤器放置位置与异常肾静脉相关的患者和滤器放置位置与任何肾静脉无关的患者之间新发肺栓塞和肾功能恶化等临床结局。

结果

共识别出97例(23.7%)肾静脉异常:62例(15.1%)右侧多条肾静脉,23例(5.6%)左肾静脉环绕主动脉,10例(2.4%)左肾静脉位于主动脉后方,2例(0.5%)左肾副静脉。滤器放置在两条左肾静脉之间或其位置的左肾静脉环绕主动脉患者中,新发肺栓塞的发生率与接受肾下或肾上滤器置入术的患者相比无显著差异(5.9%[1/17]对3.1%[12/387];P = 0.433)。IVC滤器置入术后估计肾小球滤过率下降>25%的患者频率,无论滤器放置在肾下位置还是异常肾静脉水平或其上方,均无显著差异(11.0%[37/335]对17.6%[6/34];P = 0.261)。

结论

对于肾静脉异常患者,新发肺栓塞频率和肾功能恶化等临床结局不依赖于IVC滤器的放置位置。

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