Jones B, Fink J A, Donovan D L, Sharp W V
Department of Surgery, Akron City Hospital, Ohio.
Surg Gynecol Obstet. 1989 Nov;169(5):400-2.
The Kimray-Greenfield venal caval filter is widely accepted as a means of preventing pulmonary embolism when medical anticoagulation has failed or complications have developed. When indicated, anticoagulants are usually resumed after placement of the filter. A retrospective study was performed comparing the thromboembolic and postphlebitic complications in patients who continued to receive anticoagulants after placement of the filter versus those who did not. Sixty-eight Kimray-Greenfield filters were placed in 68 patients (43 men and 25 women) during a four year period. After placement of the filter, 26 patients received anticoagulants and 42 did not. Three of those receiving anticoagulants and six of those who did not had significant swelling of the leg; two of those receiving anticoagulants and two of those who did not had a recurrent deep venous thrombosis. There were no instances of recurrent pulmonary embolism. There were no significant differences in the results of these two groups of patients. These results are consistent with those reported in the literature in that no correlation has been found between the use of anticoagulants after placement of the filter and recurrent thromboembolism or stasis sequelae. In view of the complications associated with medical anticoagulation, we recommend its discontinuation in all patients after placement of the Kimray-Greenfield filter.
当药物抗凝治疗失败或出现并发症时，金瑞-格林菲尔德腔静脉滤器被广泛认为是预防肺栓塞的一种手段。在有指征时，通常在放置滤器后恢复使用抗凝剂。进行了一项回顾性研究，比较了放置滤器后继续接受抗凝剂治疗的患者与未接受抗凝剂治疗的患者的血栓栓塞和静脉炎后并发症。在四年期间，68例患者（43例男性和25例女性）放置了68个金瑞-格林菲尔德滤器。放置滤器后，26例患者接受了抗凝剂治疗，42例未接受。接受抗凝剂治疗的患者中有3例出现腿部明显肿胀，未接受抗凝剂治疗的患者中有6例出现腿部明显肿胀；接受抗凝剂治疗的患者中有2例出现复发性深静脉血栓形成，未接受抗凝剂治疗的患者中有2例出现复发性深静脉血栓形成。没有复发性肺栓塞的病例。这两组患者的结果没有显著差异。这些结果与文献报道一致，即未发现放置滤器后使用抗凝剂与复发性血栓栓塞或静脉淤滞后遗症之间存在相关性。鉴于药物抗凝治疗相关的并发症，我们建议在放置金瑞-格林菲尔德滤器后，所有患者均停止使用抗凝剂。
