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下腔静脉滤器置入术后的血管内感染

Endovascular infection following inferior vena cava (IVC) filter insertion.

作者信息

Rottenstreich Amihai, Bar-Shalom Rachel, Bloom Allan I, Kalish Yosef

机构信息

Department of Hematology, Hadassah-Hebrew University Medical Center, POB 12000, 91120, Jerusalem, Israel.

Department of Nuclear Medicine, Sha'are Zedek Medical Center, Jerusalem, Israel.

出版信息

J Thromb Thrombolysis. 2015 Nov;40(4):452-7. doi: 10.1007/s11239-015-1219-1.

Abstract

Inferior vena cava filter (IVC) placement is increasing significantly. However, due to low retrieval rates, many filters are left in place indefinitely thereby exposing patients to long-term filter-related complications. This study reports a series of three patients with IVC filter infection. Cases were identified during retrospective review of medical records of all patients undergoing an IVC filter insertion at a single tertiary care university hospital between 2009 and 2013. Clinical presentation, radiological features and management are discussed. Two patients presented within days of filter placement, while the other one presented 1 year later. In two patients, fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) was found to be a sensitive method to diagnose IVC filter infection. Endovascular infection of IVC filter is a rare event. In patients with IVC filter in place and fever of unknown origin or persistent bacteremia, this complication should be suspected. FDG PET/CT has a diagnostic value in this challenging diagnosis.

摘要

下腔静脉滤器(IVC)置入术的应用正在显著增加。然而,由于取出率较低,许多滤器被长期留置,从而使患者面临与滤器相关的长期并发症。本研究报告了3例IVC滤器感染患者。通过回顾性查阅2009年至2013年期间在一所三级医疗大学医院接受IVC滤器置入术的所有患者的病历确定了这些病例。文中讨论了临床表现、影像学特征及治疗方法。2例患者在滤器置入后数天内出现症状,另1例在1年后出现症状。对于2例患者,氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描(FDG PET/CT)被发现是诊断IVC滤器感染的一种敏感方法。IVC滤器的血管内感染是一种罕见事件。对于留置IVC滤器且伴有不明原因发热或持续性菌血症的患者,应怀疑有此并发症。FDG PET/CT在这一具有挑战性的诊断中具有诊断价值。

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