Muchmore J H, Dunlap J N, Culicchia F, Kerstein M D
Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112.
South Med J. 1989 Nov;82(11):1352-6. doi: 10.1097/00007611-198911000-00006.
Patients with malignant gliomas are at increased risk for deep vein thrombophlebitis (DVT) and pulmonary embolism (PE). Difficult anticoagulation in cancer patients undergoing surgery, chemotherapy, or radiotherapy limit the choices of therapy for DVT. Interruption of the inferior vena cava with a Greenfield filter is a safe method of treating patients who have malignant gliomas and DVT with PE. We studied 23 patients treated for malignant gliomas; 16 were men and seven were women, with a mean age of 51 years (range, 26 to 78). Five patients had DVT shown by noninvasive blood flow studies, and four subsequently had PE, as demonstrated by ventilation perfusion lung scan; in one patient PE was diagnosed at autopsy. Of the 23 patients, four with postoperative craniotomy had DVT and all four had PE. Two of the five patients who received preoperative chemotherapy had DVT and three had PE. All patients with PE had a Greenfield filter placed in the inferior vena cava via the internal jugular vein without adverse sequelae.
恶性胶质瘤患者发生深静脉血栓形成（DVT）和肺栓塞（PE）的风险增加。接受手术、化疗或放疗的癌症患者进行抗凝治疗困难，这限制了DVT的治疗选择。使用格林菲尔德滤器阻断下腔静脉是治疗患有恶性胶质瘤且合并DVT和PE患者的一种安全方法。我们研究了23例接受恶性胶质瘤治疗的患者；其中16例为男性，7例为女性，平均年龄51岁（范围26至78岁）。5例患者经无创血流研究显示有DVT，4例随后发生PE，经通气灌注肺扫描证实；1例患者尸检时诊断为PE。在这23例患者中，4例开颅术后患者发生DVT且均发生PE。5例接受术前化疗的患者中有2例发生DVT，3例发生PE。所有发生PE的患者均通过颈内静脉在下腔静脉置入格林菲尔德滤器，无不良后遗症。
