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癌症患者中可回收下腔静脉滤器:并发症及回收成功率

Retrievable Inferior Vena Cava Filters in Patients with Cancer: Complications and Retrieval Success Rate.

作者信息

Casanegra Ana I, Landrum Lisa M, Tafur Alfonso J

机构信息

Department of Internal Medicine, Cardiovascular Section, Vascular Medicine Program, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, WP 3010, Oklahoma City, OK 73104, USA.

Department of Obstetrics and Gynecology, Section of Gynecology Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 800 NE 10th Street, Oklahoma City, OK 73104, USA.

出版信息

Int J Vasc Med. 2016;2016:6413541. doi: 10.1155/2016/6413541. Epub 2016 Jan 21.

Abstract

Active cancer (ACa) is strongly associated with venous thromboembolism and bleeding. Retrievable inferior vena cava filters (RIVCF) are frequently placed in these patients when anticoagulation cannot be continued. Objectives. To describe the complications and retrieval rate of inferior vena cava filters in patients with ACa. Methods. Retrospective review of 251 consecutive patients with RIVCF in a single institution. Results. We included 251 patients with RIVCF with a mean age of 58.1 years and a median follow-up of 5.4 months (164 days, IQR: 34-385). Of these patients 32% had ACa. There were no differences in recurrence rate of DVT between patients with ACa and those without ACa (13% versus 17%, p = ns). Also, there were no differences in major filter complications (11% ACa versus 7% no ACa, p = ns). The filter retrieval was not different between groups (log-rank = 0.16). Retrieval rate at 6 months was 49% in ACa patients versus 64% in patients without ACa (p = ns). Filter retrieval was less frequent in ACa patients with metastatic disease (p < 0.01) or a nonsurgical indication for filter placement (p = 0.04). Conclusions. No differences were noted in retrieval rate, recurrent DVT, or filter complications between the two groups. ACa should not preclude the use of RIVCF.

摘要

活动性癌症(ACa)与静脉血栓栓塞和出血密切相关。当无法继续进行抗凝治疗时,可回收下腔静脉滤器(RIVCF)常被放置于这些患者体内。目的:描述ACa患者下腔静脉滤器的并发症及取出率。方法:对一家机构中连续251例置入RIVCF的患者进行回顾性研究。结果:我们纳入了251例置入RIVCF的患者,平均年龄58.1岁,中位随访时间5.4个月(164天,四分位间距:34 - 385天)。这些患者中32%患有ACa。ACa患者与非ACa患者的深静脉血栓形成复发率无差异(13%对17%,p = 无统计学意义)。此外,主要滤器并发症也无差异(ACa患者为11%,非ACa患者为7%,p = 无统计学意义)。两组之间滤器取出情况无差异(对数秩检验 = 0.16)。ACa患者6个月时的取出率为49%,非ACa患者为64%(p = 无统计学意义)。有转移性疾病的ACa患者(p < 0.01)或因非手术指征置入滤器的ACa患者(p = 0.04)滤器取出频率较低。结论:两组在取出率、复发性深静脉血栓形成或滤器并发症方面未发现差异。ACa不应成为使用RIVCF的禁忌证。

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