Lee Jung-Kyu, So Young Ho, Choi Young Ho, Park Sung Soo, Heo Eun Young, Kim Deog Kyeom, Chung Hee Soon
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Republic of Korea.
Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Republic of Korea.
Thromb Res. 2014 Apr;133(4):538-43. doi: 10.1016/j.thromres.2014.01.004. Epub 2014 Jan 9.
The use of inferior vena cava (IVC) filters is associated with various complications. We aimed to elucidate the clinical course and predictive factors for complications of IVC filters, especially IVC penetration
A retrospective observational study was performed in 45 adult patients with retrievable IVC filters and follow-up computed tomography (CT) between January 2003 and December 2012. Primary outcomes were the prevalence and predictive factors of IVC penetration. Secondary outcome was other complications of IVC filters.
IVC penetration following filter placement occurred in 87.6% of patients, and 57.8% of those involved significant penetration. Embedding of filter tips, suggestive of lateral tilting, was observed in 51.1%. Both Vertebral body erosions and aortic penetrations were seen in 4.4%, but they were asymptomatic. Longer indwelling duration of the IVC filter was significantly associated with a higher grade of IVC penetration, and the risk of significant IVC penetration increased in patients with the filter indwelling time of more than 20 days and an IVC diameter of less than 24.2mm.
In patients with a retrievable IVC filter, IVC penetration on CT was common, and significant IVC penetration was associated with a longer indwelling time of the IVC filter and a lesser IVC diameter.
下腔静脉(IVC)滤器的使用与多种并发症相关。我们旨在阐明IVC滤器并发症的临床过程及预测因素,尤其是IVC穿孔。
对2003年1月至2012年12月期间45例植入可回收IVC滤器并接受随访计算机断层扫描(CT)的成年患者进行了一项回顾性观察研究。主要结局是IVC穿孔的发生率及预测因素。次要结局是IVC滤器的其他并发症。
滤器置入后发生IVC穿孔的患者占87.6%,其中57.8%为严重穿孔。观察到51.1%的患者滤器尖端嵌入,提示侧倾。椎体侵蚀和主动脉穿孔均占4.4%,但均无症状。IVC滤器留置时间较长与IVC穿孔程度较高显著相关,滤器留置时间超过20天且IVC直径小于24.2mm的患者发生严重IVC穿孔的风险增加。
在植入可回收IVC滤器的患者中,CT显示IVC穿孔很常见,严重IVC穿孔与IVC滤器留置时间较长和IVC直径较小有关。