Zhong Anny, Trerotola Scott O, Stavropoulos S William
Division of Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Division of Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
J Vasc Interv Radiol. 2023 Apr;34(4):529-533. doi: 10.1016/j.jvir.2022.12.005. Epub 2022 Dec 9.
To report results of 16 years of using the endobronchial forceps technique to remove embedded inferior vena cava (IVC) filters.
Between January 2005 and June 2021, 534 patients (310 women and 224 men) with a mean age of 52 years (standard deviation [SD] ± 16 years) presented for complex filter retrieval of 535 tip- or strut-embedded IVC filters. Tip-embedded filters were diagnosed on rotational venography. Filters were considered strut-embedded if they were closed-cell filters with dwell times of >6 months. The filter was dissected from the IVC using rigid bronchoscopy forceps and removed through a vascular sheath.
The endobronchial forceps technique was successful in 530 of 537 retrieval attempts on an intention-to-treat basis (98.7%); a total of 530 filters were retrieved. There were 7 failures: (a) 5 failed retrieval attempts (2 that were retrieved successfully in subsequent procedures) and (b) 2 for which retrieval was not attempted. The mean filter dwell time was 1,459 days (SD ± 1,617 days). Laser sheaths were not used for any removal. Filters included herein were 137 Celect (94 Celect and 43 Celect Platinum), 99 Günther Tulip, 72 Option (48 Option and 24 Option Elite), 68 G2, 45 G2X/Eclipse, 42 Denali, 30 OptEase, 29 Recovery, 7 Meridian, and 6 ALN with Hook filters. Thirty-four minor (6.3%) and 11 major (2%) adverse events (AEs) occurred, which did not result in permanent sequelae.
Use of endobronchial forceps for removal of tip- and strut-embedded retrievable IVC filters is effective and has low AE rates.
报告应用支气管内钳技术取出嵌入下腔静脉（IVC）滤器16年的结果。
2005年1月至2021年6月，534例患者（310例女性和224例男性），平均年龄52岁（标准差[SD]±16岁），因复杂的滤器取出术前来就诊，涉及535个尖端或支柱嵌入的IVC滤器。尖端嵌入的滤器通过旋转静脉造影诊断。如果是闭孔滤器且留置时间>6个月，则视为支柱嵌入。使用硬支气管镜钳从IVC中分离滤器，并通过血管鞘取出。
在意向性治疗的基础上，537次取出尝试中有530次（98.7%）成功应用支气管内钳技术；共取出530个滤器。有7次失败：（a）5次取出尝试失败（其中2次在后续手术中成功取出），（b）2次未尝试取出。滤器平均留置时间为1459天（SD±1617天）。所有取出均未使用激光鞘。本文中的滤器包括137个Celect（94个Celect和43个Celect Platinum）、99个Günther Tulip、72个Option（48个Option和24个Option Elite）、68个G2、45个G2X/Eclipse、42个Denali、30个OptEase、29个Recovery、7个Meridian和6个带钩的ALN滤器。发生了34例轻微（6.3%）和11例严重（2%）不良事件（AE），均未导致永久性后遗症。
应用支气管内钳取出尖端和支柱嵌入的可取出IVC滤器是有效的，且不良事件发生率低。
