Kang Jieun, Ko Heung-Kyu, Shin Ji Hoon, Ko Gi-Young, Jo Kyung-Wook, Huh Jin Won, Oh Yeon-Mok, Lee Sang-Do, Lee Jae Seung
1 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
2 Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Vasc Med. 2017 Dec;22(6):512-517. doi: 10.1177/1358863X17726596. Epub 2017 Sep 7.
Retrievable inferior vena cava (IVC) filters are increasingly used in patients with venous thromboembolism (VTE) who have contraindications to anticoagulant therapy. However, previous studies have shown that many retrievable filters are left permanently in patients. This study aimed to identify the common indications for IVC filter insertion, the filter retrieval rate, and the predictive factors for filter retrieval attempts. To this end, a retrospective cohort study was performed at a tertiary care center in South Korea between January 2010 and May 2016. Electronic medical charts were reviewed for patients with pulmonary embolism (PE) who underwent IVC filter insertion. A total of 439 cases were reviewed. The most common indication for filter insertion was a preoperative/procedural aim, followed by extensive iliofemoral deep vein thrombosis (DVT). Retrieval of the IVC filter was attempted in 44.9% of patients. The retrieval success rate was 93.9%. History of cerebral hemorrhage, malignancy, and admission to a nonsurgical department were the significant predictive factors of a lower retrieval attempt rate in multivariate analysis. With the increased use of IVC filters, more issues should be addressed before placing a filter and physicians should attempt to improve the filter retrieval rate.
可回收下腔静脉（IVC）滤器越来越多地用于对抗凝治疗有禁忌证的静脉血栓栓塞症（VTE）患者。然而，既往研究表明，许多可回收滤器被永久留在患者体内。本研究旨在确定IVC滤器置入的常见适应证、滤器回收成功率以及滤器回收尝试的预测因素。为此，于2010年1月至2016年5月在韩国一家三级医疗中心进行了一项回顾性队列研究。对接受IVC滤器置入的肺栓塞（PE）患者的电子病历进行了回顾。共回顾了439例病例。滤器置入最常见的适应证是术前/手术目的，其次是广泛的髂股深静脉血栓形成（DVT）。44.9%的患者尝试回收IVC滤器。回收成功率为93.9%。在多因素分析中，脑出血病史、恶性肿瘤以及入住非外科科室是回收尝试率较低的显著预测因素。随着IVC滤器使用的增加，在放置滤器之前应解决更多问题，医生应努力提高滤器回收成功率。
