Department of Internal Medicine, University of California, Irvine, Orange, Calif.
Section of Interventional Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio.
J Vasc Surg Venous Lymphat Disord. 2018 Sep;6(5):599-605. doi: 10.1016/j.jvsv.2018.03.012. Epub 2018 Jun 21.
To retrospectively investigate the safety, efficacy, and complications associated with TrapEase inferior vena cava filters.
All patients who received a TrapEase filter at a single institution between April 2003 and January 2013 were identified, and outcomes were reviewed and analyzed.
During the study period, 594 patients (278 women; mean age, 68.9 ± 13.6 years; range, 19.2-96.3 years) received a TrapEase filter. The duration of this study was 88 months, with a median clinical follow-up of 3.6 months (range, 0-148.3 months). During follow-up, 489 of 594 patients (82.3%) died and 105 remained alive with filters in situ. Nine cases of breakthrough pulmonary embolism occurred among the 582 patients with clinical follow-up (1.5%). Among 128 patients with imaging that contained the filter, there were 17 cases of filter fracture (13.3%). Of the 39 patients with available computed tomography scans, eight had filling defects within the filter suggestive of thrombus or embolus (20.5%), including two patients with complete caval occlusion. Recurrent deep vein thrombosis occurred in 109 out of 582 patients (18.7%) with clinical follow-up.
Most patients who received TrapEase filters died during follow-up, possibly because operators chose to implant a permanent filter in patients with known terminal illnesses. The filter fracture rate seemed to be high, but there were no instances of free fracture fragment or distant migration. Although the filter may theoretically be effective in preventing thrombus migration owing to the double basket design, pulmonary embolism breakthrough rates were comparable with rates seen with other filters.
回顾性调查 TrapEase 下腔静脉滤器的安全性、有效性和相关并发症。
在单一机构中，于 2003 年 4 月至 2013 年 1 月期间，对所有接受 TrapEase 滤器的患者进行了鉴定，并对结果进行了回顾和分析。
在研究期间，594 例患者（278 例女性；平均年龄 68.9±13.6 岁；年龄范围 19.2-96.3 岁）接受了 TrapEase 滤器。研究持续 88 个月，中位临床随访 3.6 个月（范围，0-148.3 个月）。在随访期间，594 例患者中有 489 例（82.3%）死亡，105 例仍存活且滤器在位。582 例有临床随访的患者中有 9 例发生了穿透性肺栓塞（1.5%）。在 128 例有影像学资料的患者中，有 17 例滤器发生了断裂（13.3%）。在 39 例可获得计算机断层扫描的患者中，有 8 例发现滤器内有充盈缺损，提示血栓或栓子（20.5%），其中包括 2 例完全下腔静脉闭塞。582 例有临床随访的患者中有 109 例发生了复发性深静脉血栓形成（18.7%）。
大多数接受 TrapEase 滤器的患者在随访期间死亡，这可能是因为术者选择在患有已知终末期疾病的患者中植入永久性滤器。滤器断裂率似乎较高，但没有游离的断裂碎片或远处迁移的情况。尽管由于双篮设计，该滤器理论上可能有效防止血栓迁移，但肺栓塞穿透率与其他滤器的穿透率相当。
