Son Joohyung, Bae Miju, Chung Sung Woon, Lee Chung Won, Huh Up, Song Seunghwan
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital.
Korean J Thorac Cardiovasc Surg. 2017 Dec;50(6):443-447. doi: 10.5090/kjtcs.2017.50.6.443. Epub 2017 Dec 5.
The inferior vena cava filter (IVCF) is very effective for preventing pulmonary embolism in patients who cannot undergo anticoagulation therapy. However, if a filter is placed in the body permanently, it may lead to other complications.
A retrospective study was performed of 159 patients who underwent retrievable Cook Celect IVCF implantation between January 2007 and April 2015 at a single center. Baseline characteristics, indications, and complications caused by the filter were investigated.
The most common underlying disease of patients receiving the filter was cancer (24.3%). Venous thrombolysis or thrombectomy was the most common indication for IVCF insertion in this study (47.2%). The most common complication was inferior vena cava penetration, the risk of which increased the longer the filter remained in the body (p=0.032, Exp(B)=1.004).
If the patient is able to retry anticoagulation therapy and the filter is no longer needed, the filter should be removed, even if a long time has elapsed since implantation. If the filter cannot be removed, it is recommended that follow-up computed tomography be performed regularly to monitor the progress of venous thromboembolisms as well as any filter-related complications.
下腔静脉滤器(IVCF)对于无法接受抗凝治疗的患者预防肺栓塞非常有效。然而,如果滤器永久放置在体内,可能会导致其他并发症。
对2007年1月至2015年4月在单一中心接受可回收Cook Celect IVCF植入的159例患者进行回顾性研究。调查患者的基线特征、植入滤器的指征以及滤器引起的并发症。
接受滤器植入的患者最常见的基础疾病是癌症(24.3%)。在本研究中,静脉溶栓或血栓切除术是IVCF植入最常见的指征(47.2%)。最常见的并发症是下腔静脉穿孔,滤器在体内留置时间越长,发生该并发症的风险越高(p = 0.032,Exp(B)=1.004)。
如果患者能够重新尝试抗凝治疗且不再需要滤器,即使滤器植入后已过去很长时间,也应将其取出。如果滤器无法取出,建议定期进行计算机断层扫描随访,以监测静脉血栓栓塞的进展以及任何与滤器相关的并发症。