Department of Vascular Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY.
Department of Vascular Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY.
J Vasc Surg Venous Lymphat Disord. 2024 Mar;12(2):101687. doi: 10.1016/j.jvsv.2023.09.001. Epub 2023 Sep 12.
The objective of this study was to help guide inferior vena cava (IVC) filter choices by better understanding the retrieval characteristics, complications, and total costs between two commonly used IVC filters.
All patients who underwent retrieval or attempted retrieval of Denali (Bard Peripheral Vascular) or Option (Argon Medical Devices) IVC filters were identified between March 2016 and October 2021 at a single tertiary care center. Those with imaging studies that permitted evaluation of filter placement, presence or degree of tilt, and/or hooking of the filter into the IVC wall were included in the present study. Filter retrieval success, number of attempts, use of advanced techniques, and fluoroscopy and procedural times were recorded and compared between the two filters.
A total of 87 patients presented for retrieval of 52 Denali and 35 Option Elite filters during the study period. Denali filters were more likely to be successfully retrieved at the first attempt (94% vs 77%; P = .019). The procedural and fluoroscopy times were shorter for Denali filters (29 minutes vs 63 minutes [P < .001] and 7 minutes vs 25 minutes [P < .001], respectively). Denali filters were less likely to be significantly tilted (≥15) at retrieval (12% vs 29%; P < .001) or to have the filter hook embedded in the IVC wall (6% vs 40%; P < .001). Tilting of the filter of ≥15 had no significant effects on the retrieval success rate (no tilt or tilt <15 vs tilt of ≥15: 98% vs 100%; P = .58). In contrast, filter hook penetration into the IVC wall significantly reduced successful recovery (41% vs 99%; P < .001).
The findings from this study suggest that although the filter designs are similar, a benefit exists in the ease of retrievability of the Denali over the Option filter. We found that tilting and hooking of the filter in the IVC wall occurred significantly more with the Option filter. These factors likely made retrieval more difficult and contributed to the longer procedure and fluoroscopy times.
本研究旨在通过更好地了解两种常用下腔静脉（IVC）滤器的取出特点、并发症和总费用，为 IVC 滤器的选择提供指导。
在单中心的一家三级医疗中心，于 2016 年 3 月至 2021 年 10 月期间，对所有接受德纳西（Bard 外周血管）或奥创（Argon 医疗设备）IVC 滤器取出或试图取出的患者进行了识别。本研究纳入了有影像学检查的患者，这些检查可评估滤器的放置位置、滤器的倾斜程度和/或滤器与 IVC 壁的钩状情况。记录并比较了两种滤器的取出成功率、尝试次数、使用高级技术、透视和手术时间。
在研究期间，共有 87 例患者接受了 52 个德纳西和 35 个奥创 Elite 滤器的取出。首次尝试时，德纳西滤器的取出成功率更高（94%比 77%；P=0.019）。德纳西滤器的手术和透视时间更短（29 分钟比 63 分钟[P<0.001]和 7 分钟比 25 分钟[P<0.001]）。取出时，德纳西滤器的倾斜程度（≥15°）较小（12%比 29%；P<0.001），滤器钩嵌入 IVC 壁的情况也较少（6%比 40%；P<0.001）。滤器的倾斜程度≥15°对取出成功率没有显著影响（无倾斜或倾斜<15°与倾斜≥15°：98%比 100%；P=0.58）。相比之下，滤器钩穿透 IVC 壁会显著降低恢复成功率（41%比 99%；P<0.001）。
本研究结果表明，尽管两种滤器的设计相似，但在可取出性方面，德纳西滤器优于奥创滤器。我们发现，奥创滤器在 IVC 壁上的倾斜和钩状情况更为常见。这些因素可能使取出变得更加困难，并导致手术和透视时间延长。
