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在复杂滤器取出术后下腔静脉损伤的初始处理中,延长球囊填塞时间,无需手术。

Prolonged balloon tamponade in the initial management of inferior vena cava injury following complicated filter retrieval, without the need for surgery.

作者信息

Lee Jonathan Tl, Goh Gerard S, Joseph Tim, Koukounaras Jim, Phan Tuan, Clements Warren

机构信息

Department of Radiology, Alfred Health, Melbourne, Victoria, Australia.

Monash University, Melbourne, Victoria, Australia.

出版信息

J Med Imaging Radiat Oncol. 2018 Dec;62(6):810-813. doi: 10.1111/1754-9485.12758. Epub 2018 Jul 5.

Abstract

Advanced techniques have been described to remove embedded inferior vena cava (IVC) filters including the loop snare and modified loop snare (Hangman) techniques. Retrieval of embedded filters have been associated with higher rates of complications including IVC injury and stenosis. We report two challenging embedded retrievals complicated by IVC injury and haemorrhage. Haemostasis was successfully achieved with prolonged balloon tamponade, suggesting that injury to the IVC during filter retrieval may not need urgent surgery. However, both patients received short-term complications related to caval thrombosis and patients in this cohort should be closely observed after retrieval. These cases support rigorous attention to filter indication and follow-up.

摘要

已经描述了用于取出植入的下腔静脉(IVC)滤器的先进技术,包括圈套器和改良圈套器(刽子手)技术。取出植入的滤器与包括下腔静脉损伤和狭窄在内的更高并发症发生率相关。我们报告了两例具有挑战性的植入滤器取出病例,均并发下腔静脉损伤和出血。通过延长球囊压迫成功实现了止血,这表明在滤器取出过程中下腔静脉损伤可能不需要紧急手术。然而,两名患者均出现了与腔静脉血栓形成相关的短期并发症,该队列中的患者在取出滤器后应密切观察。这些病例支持对滤器植入指征和随访给予严格关注。

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