Park Hyeongmin, Han Ahram, Choi Chanjoong, Min Sang-Il, Ha Jongwon, Jung In Mok, Lee Taeseung, Kim Hyo-Cheol, Jae Hwan Joon, Min Seung-Kee
Departments of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Radiology, Seoul National University College of Medicine, Seoul, Korea.
Vasc Specialist Int. 2014 Dec;30(4):133-8. doi: 10.5758/vsi.2014.30.4.133. Epub 2014 Dec 31.
The purpose of this study was to review the daily practice of inferior vena cava filters (IVCFs) in a tertiary referral center in Korea and to reveal the retrieval rate and the methods for improving it.
Through the electronic medical record system, a retrospective review was performed on 115 consecutive patients who underwent placement of retrievable IVCFs between February 2000 and January 2011 in Seoul National University Hospital.
IVCF placement was done in 115 cases (113 patients). There were 68 men (59.1%), and the mean age was 58.5±15.5 years (range, 10-96 years). The affiliated departments were Vascular Surgery (57 cases, 49.6%), and Internal Medicine (20 cases, 17.4%). Advanced malignancy was the most commonly associated disease (n=30, 26%). The indications for IVCF placement were categorized; absolute indications in 36 cases (31.3%), relative indications in 78 cases (67.8%), and prophylactic use in 1 case (0.9%). The most common indications were thrombolysis/thrombectomy for iliocaval deep vein thrombosis (DVT) (n=55, 47.8). Of the 115 filters, 68 were retrieved (retrieval rate, 59%). The most common cause of non-retrieval was chronic high risk of venous thromboembolism in 24 patients (51%), followed by residual proximal DVT (n=7, 15%), and negligence by unknown reasons (n=6, 13%).
To improve the retrieval rate, the number of follow-up losses to vascular specialists must be decreased, which can be achieved by establishment of a dedicated IVC filter clinic, implementation of a filter registry, and regular education for medical teams and patients along with their families.
本研究旨在回顾韩国一家三级转诊中心下腔静脉滤器（IVCF）的日常使用情况，并揭示其取出率及提高取出率的方法。
通过电子病历系统，对2000年2月至2011年1月在首尔国立大学医院连续接受可取出式IVCF置入术的115例患者进行回顾性研究。
共进行了115例IVCF置入术（涉及113例患者）。其中男性68例（59.1%），平均年龄为58.5±15.5岁（范围10 - 96岁）。相关科室包括血管外科（57例，49.6%）和内科（20例，17.4%）。晚期恶性肿瘤是最常见的相关疾病（30例，26%）。IVCF置入的适应证进行了分类：绝对适应证36例（31.3%），相对适应证78例（67.8%），预防性使用1例（0.9%）。最常见的适应证是髂股静脉深静脉血栓形成（DVT）的溶栓/血栓切除术（55例，47.8%）。115枚滤器中，68枚被取出（取出率为59%）。未取出的最常见原因是24例患者（51%）存在慢性静脉血栓栓塞高风险，其次是残留近端DVT（7例，15%），以及不明原因的疏忽（6例，13%）。
为提高取出率，必须减少血管专科医生随访失访的数量，这可以通过建立专门的IVC滤器门诊、实施滤器登记制度以及对医疗团队和患者及其家属进行定期教育来实现。
