Mozgovoĭ P V, Ziubina E N, Spiridonov E G, Vorob'ev A A, Mandrikov V V, Zharkin F N, Lukovskova A A, Ufimtsev V S
Clinic #1, Volgograd State Medical University of the RF Ministry of Public Health, Volgograd, Russia.
Angiol Sosud Khir. 2020;26(4):149-154. doi: 10.33529/ANGIO2020422.
Despite the fact that prevention and treatment of venous thromboembolic complications are based on anticoagulant therapy in cases where there are contraindications, complications, as well as in case of inefficiency of the carried out anticoagulant therapy, installation of a cava filter is indicated. The necessity of subsequent retrieval of this device from the inferior vena cava is associated with a potential risk of the development of complications. Analysed herein is a case series concerning management of 4 patients undergoing treatment from February 2015 to March 2017. Attempts of endovascular retrieval of the cava filter turned out unsuccessful. The patients were therefore subjected to total laparoscopic retrieval of the cava filter. The time required for phlebotomy, retrieval of the filter, and suturing of the phlebectomy zone ranged from 32 to 45 min. The maximal blood loss amounted to 300 ml, not requiring transfusion of blood preparations. Neither was required conversion to laparotomy in any case. No significant systemic or wound complications in the postoperative period were observed. A conclusion drawn is that in case of failed attempts at endovascular retrieval, given that a surgical team has broad experience in performing laparoscopic and angiosurgical operations, total laparoscopic retrieval of a cava filter may be considered a relatively safe minimally invasive method of managing the patient cohort concerned.
尽管静脉血栓栓塞并发症的预防和治疗在存在禁忌症、出现并发症以及所实施的抗凝治疗无效的情况下均基于抗凝治疗，但在这些情况下仍需植入下腔静脉滤器。后续从下腔静脉取出该装置的必要性与并发症发生的潜在风险相关。本文分析了2015年2月至2017年3月期间接受治疗的4例患者的管理病例系列。经血管内取出下腔静脉滤器的尝试均未成功。因此，对这些患者进行了全腹腔镜下下腔静脉滤器取出术。静脉切开术、滤器取出术以及静脉切除区域缝合所需时间为32至45分钟。最大失血量为300毫升，无需输血。在任何情况下均无需转为开腹手术。术后未观察到明显的全身或伤口并发症。得出的结论是，在经血管内取出尝试失败的情况下，鉴于手术团队在进行腹腔镜和血管外科手术方面有丰富经验，全腹腔镜下下腔静脉滤器取出术可被视为管理相关患者群体的一种相对安全的微创方法。
