选择性腔静脉滤器取出术的成功：246例患者分析

Success in Optional Vena Cava Filter Retrieval. An Analysis of 246 Patients.

作者信息

de Gregorio Miguel A, Guirola José A, Serrano Carol, Figueredo Ana, Kuo Willian T, Quezada Carlos Andrés, Jimenez David

机构信息

Grupo de Investigación en Técnicas Mínimamente Invasivas (GITMI), Universidad de Zaragoza, Hospital Clínico Lozano Blesa, Zaragoza, España; Servicio de Neumología, Hospital Miguel Servet, Zaragoza, España.

Division of Vascular and Interventional Radiology, Department of Radiology, Stanford University Medical Center, Standford, CA, United States.

出版信息

Arch Bronconeumol (Engl Ed). 2018 Jul;54(7):371-377. doi: 10.1016/j.arbres.2018.02.008. Epub 2018 Mar 19.

DOI:10.1016/j.arbres.2018.02.008

PMID:29566970

Abstract

OBJECTIVE

This study assessed vena cava filter (VCF) retrieval rates and factors associated with retrieval failure in a single center cohort.

METHODS

We conducted an observational retrospective cohort study. The primary endpoint was the percentage of patients whose VCF was retrieved. We performed logistic regression to identify variables associated with retrieval failure.

RESULTS

During the study period, 246 patients received a VCF and met the eligibility requirements to be included in the study; 151 (61%) patients received a VCF due to contraindication to anticoagulation, 69 (28%) patients had venous thromboembolism (VTE) and a high risk of recurrence, and 26 (11%) patients received a filter due to recurrent VTE while on anticoagulant therapy. Of 236 patients who survived the first month after diagnosis of VTE, VCF was retrieved in 96%. Retrieval rates were significantly lower for patients with recurrent VTE while on anticoagulation, compared with patients with contraindication to anticoagulation or patients with a high risk of recurrence (79% vs. 97% vs. 100%, respectively; P<0.01). Mean time to retrieval attempt was significantly associated with retrieval failure (137.8 ± 65.3 vs. 46.3 ± 123.1 days, P<0.001).

CONCLUSIONS

In this single center study, VCF retrieval success was 96%. A delay in the attempt to retrieve the VCF correlated significantly with retrieval failure.

摘要

目的

本研究评估了单中心队列中腔静脉滤器（VCF）的取出率以及与取出失败相关的因素。

方法

我们进行了一项观察性回顾性队列研究。主要终点是VCF被取出的患者百分比。我们进行逻辑回归以确定与取出失败相关的变量。

结果

在研究期间，246例患者接受了VCF并符合纳入本研究的资格要求；151例（61%）患者因抗凝禁忌而接受VCF，69例（28%）患者有静脉血栓栓塞（VTE）且复发风险高，26例（11%）患者在接受抗凝治疗时因复发性VTE而接受了滤器。在236例VTE诊断后存活第一个月的患者中，96%的患者取出了VCF。与有抗凝禁忌的患者或复发风险高的患者相比，接受抗凝治疗时复发性VTE的患者取出率显著较低（分别为79%对97%对100%；P<0.01）。取出尝试的平均时间与取出失败显著相关（137.8±65.3天对46.3±123.1天，P<0.001）。