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传统方法下下腔静脉滤器取出失败:原因分析及改良双环技术取出

Failed inferior vena cava filter retrieval by conventional method: Analysis of its causes and retrieval of it by modified double-loop technique.

作者信息

Cho Eun, Lim Kyung Jae, Jo Jeong Hyun, Jung Gyoo-Sik, Park Byeong Ho

机构信息

Department of Radiology, Dong-A University Hospital, South Korea.

Department of Radiology, Kosin University Gospel Hospital, South Korea.

出版信息

Phlebology. 2015 Sep;30(8):549-56. doi: 10.1177/0268355514545353. Epub 2014 Aug 5.

Abstract

OBJECTIVES

To evaluate the complications of the temporary implanted inferior vena cava (IVC) filter and the feasibility of double-loop technique for removal of complicated IVC filters.

METHODS

From January 2012 to December 2013, a total of 25 patients with IVC filter were referred for IVC filter retrieval. There were 20 Celect®, 3 OptEase®, and 2 Günther-Tulip® filters. All of the patients were evaluated with a pre-procedural CT scan to identify any complications. The IVC filters which had failed to be retrieved by the conventional method were evaluated, and retrieval was attempted with double loop technique.

RESULTS

Sixteen of 25 (64%) filters had complications; IVC wall penetration (n = 11, 44%), tilted within IVC (n = 6, 24%), embedded struts (n = 3, 12%), and fracture of the strut (n = 1, 4%). The complications were overlapped in five patients. Two of them (8%) had also complained of filter-related pain. The success rate of IVC filter retrieval by double-loop technique was 14/16 (87.5%). There was no major filter retrieval-related complications.

CONCLUSIONS

The double-loop technique is a safe and feasible method for complicated IVC filter retrieval.

摘要

目的

评估临时植入下腔静脉(IVC)滤器的并发症以及采用双环技术取出复杂IVC滤器的可行性。

方法

2012年1月至2013年12月,共有25例植入IVC滤器的患者前来进行IVC滤器取出术。其中有20枚Celect®滤器、3枚OptEase®滤器和2枚Günther-Tulip®滤器。所有患者在术前均接受CT扫描以确定有无并发症。对采用传统方法未能取出的IVC滤器进行评估,并尝试用双环技术取出。

结果

25枚滤器中有16枚(64%)出现并发症;下腔静脉壁穿透(n = 11,44%)、在下腔静脉内倾斜(n = 6,24%)、支柱嵌入(n = 3,12%)和支柱断裂(n = 1,4%)。5例患者存在多种并发症。其中2例(8%)还诉说有与滤器相关的疼痛。采用双环技术取出IVC滤器的成功率为14/16(87.5%)。未出现与滤器取出相关的严重并发症。

结论

双环技术是一种安全可行的取出复杂IVC滤器的方法。

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