Minocha Jeet, Smith Aaron M, Kapoor Baljendra S, Fidelman Nicholas, Cain Thomas R, Caplin Drew M, Eldrup-Jorgensen Jens, Farsad Khashayar, Gupta Amit, Lee Margaret H, McBride Joseph J, Moores Lisa K, Rochon Paul J, Lorenz Jonathan M
University of California San Diego, San Diego, California.
Research Author, University of California San Diego, San Diego, California.
J Am Coll Radiol. 2019 May;16(5S):S214-S226. doi: 10.1016/j.jacr.2019.02.010.
Venous thromboembolism (VTE)-deep vein thrombosis and pulmonary embolism-is a common cause of morbidity and mortality. The mainstay of VTE prophylaxis and therapy is anticoagulation. In select patients with VTE, inferior vena cava (IVC) filters are used to prevent pulmonary embolism by trapping emboli as they pass from the lower extremity venous system through the IVC. These guidelines review the indications for placement of IVC filters in acute and chronic VTE, as well as the indications for retrieval of implanted IVC filters. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
静脉血栓栓塞症（VTE）——深静脉血栓形成和肺栓塞——是发病和死亡的常见原因。VTE预防和治疗的主要手段是抗凝。在特定的VTE患者中，下腔静脉（IVC）滤器用于在栓子从下肢静脉系统经下腔静脉通过时捕获栓子，从而预防肺栓塞。本指南回顾了在急性和慢性VTE中放置IVC滤器的适应证，以及取出植入的IVC滤器的适应证。美国放射学会适宜性标准是针对特定临床情况的循证指南，每年由多学科专家小组进行审查。指南的制定和修订包括对同行评审期刊上当前医学文献的广泛分析，以及应用成熟的方法（兰德/加州大学洛杉矶分校适宜性方法和推荐评估、制定与评价分级或GRADE）来评估特定临床场景下成像和治疗程序的适宜性。在缺乏证据或证据不明确的情况下，专家意见可补充现有证据以推荐成像或治疗。
