De Oliveira Leite Tulio Fabiano, Silva Thiago Oliveira E, Pereira Osvaldo Ignacio, Carnevale Francisco Cesar
São Paulo University, Rua Lisboa, 257, APT 72, Cerqueira César, São Paulo, 05413-000, Brazil.
São Paulo University. Av. Dr. Enéas de Carvalho Aguiar, 255 - Cerqueira César, São Paulo, SP, 05403-000, Brazil.
Int J Surg Case Rep. 2020;73:105-108. doi: 10.1016/j.ijscr.2020.06.100. Epub 2020 Jun 29.
Venous thromboembolism is an important cause of morbidity and mortality in the world. Upper Extremity Deep Venous Thrombosis (UEDVT) may be a cause of pulmonary embolism. Anticoagulation is the treatment of choice for venous thromboembolism, which is associated with low hemorrhagic complications. However, there are situations that anticoagulation becomes contraindicated as gastrointestinal tract hemorrhages, stroke, progression of deep venous thrombosis in the presence of adequate anticoagulation, where the vena cava filter is recommended.
Patient 65 years old, female undergoing neurosurgical treatment of a mass suggestive of schwannoma with asymmetrical edema in the right upper limb, confirming the acute deep venous thrombosis by Doppler ultrassonogarphy. Anticoagulation was contraindicated by neurosurgery and after a multidisciplinary discussion, the superior vena cava filter was chosen.
The Retrievable Celect™ Filter was implant in superior vena cava and may be considered as an alternative therapeutic method in cases where anticoagulation can not be performed.
Superior vena cava filter is controversial, but is safe, feasible and effective, in preventing symptomatic pulmonary embolisms in patients in whom anticoagulation is contraindicated.
静脉血栓栓塞是全球发病和死亡的重要原因。上肢深静脉血栓形成（UEDVT）可能是肺栓塞的一个原因。抗凝是静脉血栓栓塞的首选治疗方法，其出血并发症发生率较低。然而，在存在胃肠道出血、中风、抗凝充分时深静脉血栓仍进展等情况下，抗凝治疗会成为禁忌，此时推荐植入腔静脉滤器。
一名65岁女性患者，正在接受神经外科手术治疗疑似神经鞘瘤的肿块，右上肢出现不对称水肿，经多普勒超声检查确诊为急性深静脉血栓形成。由于神经外科手术，抗凝治疗存在禁忌，经过多学科讨论后，选择了上腔静脉滤器。
可回收的Celect™滤器植入上腔静脉，在无法进行抗凝治疗的情况下可被视为一种替代治疗方法。
上腔静脉滤器存在争议，但在抗凝治疗禁忌的患者中，它在预防有症状的肺栓塞方面是安全、可行且有效的。
