Hinojosa Carlos A, Olivares-Cruz Sandra, Laparra-Escareno Hugo, Gomez-Arcive Zeniff, Anaya-Ayala Javier E
Surgery Directorate, Division of Angiology, Vascular Surgery, and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México.
Arch Cardiol Mex. 2019;89(3):196-201. doi: 10.24875/ACME.M19000064.
Anticoagulation is the primary management to prevent venous thromboembolism; inferior vena cava filters (IVCFs) provide a mechanical prophylactic alternative when anticoagulation is contraindicated. The aim of this study was to evaluate in IVCF patients, whether the initiation of anticoagulation therapy is associated with decreased rates of recurrent thrombotic events and device-related complications.
This was a retrospective review of patients that underwent insertion of IVCF. Subjects with IVCF were studied in two groups: those initiated on anticoagulation (A) and without anticoagulation (NA). Variables as indications for IVCF, anticoagulation, recurrence of thrombosis, complications, and reinterventions were examined.
From April 2007 to March 2014, 54 patients underwent IVCF placement; (61% of females), with mean age of 54 years (standard deviation ± 19). 28 (52%) were initiated on anticoagulation, during a mean follow-up period of 28 months, five experienced recurrent thrombosis and three were on the A group (p=0.5); when comparing patients that developed post-thrombotic syndrome, seven were in the A group and seven in the NA. Two patients with IVC rupture were in the A group (p=0.5), and the only case of IVCF migration occurred in the A group. 11 (20%) patients died from comorbidities nonrelated to the device or procedure (four in the A cohort).
Patients with IVCF on anticoagulation have equivalent rates of thrombotic events and device-related complications than those patients NA.
抗凝是预防静脉血栓栓塞的主要治疗方法;当抗凝治疗禁忌时,下腔静脉滤器(IVCF)可提供一种机械性预防替代方案。本研究的目的是评估在植入IVCF的患者中,启动抗凝治疗是否与复发性血栓事件发生率和器械相关并发症的降低有关。
这是一项对接受IVCF植入患者的回顾性研究。将植入IVCF的患者分为两组进行研究:启动抗凝治疗的患者(A组)和未进行抗凝治疗的患者(NA组)。对IVCF植入指征、抗凝治疗、血栓复发、并发症及再次干预等变量进行了研究。
2007年4月至2014年3月,54例患者接受了IVCF植入术;其中女性占61%,平均年龄54岁(标准差±19)。28例(52%)患者启动了抗凝治疗,平均随访期为28个月,5例发生复发性血栓形成,其中3例在A组(p=0.5);比较发生血栓后综合征的患者,A组有7例,NA组有7例。A组有2例发生下腔静脉破裂(p=0.5),IVCF移位的唯一1例发生在A组。11例(20%)患者死于与器械或手术无关的合并症(A组队列中有4例)。
接受抗凝治疗的IVCF患者与未接受抗凝治疗的患者相比,血栓事件发生率和器械相关并发症发生率相当。