Department of Interventional and Vascular Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, P.R. China.
Department of Interventional and Vascular Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, P.R. China.
J Vasc Surg Venous Lymphat Disord. 2024 Jul;12(4):101862. doi: 10.1016/j.jvsv.2024.101862. Epub 2024 Feb 28.
This study aimed to characterize radiographic characteristics on computed tomography venography and risk factors of inferior vena cava thrombosis (IVCT) in situ after retrievable vena cava filter (VCF) placement.
Between September 2018 and June 2023, a single-center retrospective cohort study was conducted in patients with or without IVCT in situ following VCF placement. Patient baseline demographics, presentation of lower extremity deep vein thrombosis (LEDVT), thrombus characteristics, concurrent pulmonary embolism, comorbidities and risk factors for LEDVT, and IVCT and VCF-related information were collected and analysed. Univariable analysis followed by multivariable analysis was performed to evaluate the odds ratio (OR) with a 95% confidence interval (CI).
One hundred and seventeen eligible patients were included, regionally isolated filling-defect surrounding the support pillars of VCF and contacting inferior vena cava (IVC) wall on computed tomography venography images were identified, clots were more frequently found on the minor axis or anterior wall of IVC. Univariable analyses suggested that the incidence of IVCT in situ (31.6%, 37/117) was closely associated with age (P = .001), thrombus limb (left (P = .001) and bilateral side (P = .001)), hypertension (P = .008), filter shapes (P < .001), short IVC diameter (P = .009) or magnification percentage (P = .004), and long IVC diameter (P = .006). Multivariable analyses suggested that bilateral side LEDVT (OR, 4.92; 95% CI, 1.56-15.51; P = .007) and increased short IVC magnification percentage (OR, 1.01; 95% CI, 1.00-1.03; P = .013) statistically significant increase the IVCT in situ risk, whereas increased age (OR, 0.96; 95% CI, 0.94-0.99; P = .013) and short IVC diameter (OR, 0.87; 95% CI, 0.77-0.98; P = .026) were associated with decreased odds against IVCT in situ.
IVCT in situ represents regionally isolated filling-defect at points of filter contact with IVC wall. Bilateral side LEDVT and increased short IVC magnification percentage may be potential risk factors impacting the occurrence of IVCT in situ, while increased age and short IVC diameter may decrease the incidence of IVCT in situ and seem to be protective factor against IVCT in situ emergence.
本研究旨在描述可回收下腔静脉滤器（VCF）放置后下腔静脉血栓（IVCT）原位的 CT 静脉造影的影像学特征和相关危险因素。
本单中心回顾性队列研究纳入了 2018 年 9 月至 2023 年 6 月间 VCF 放置后存在或不存在 IVCT 原位的患者。收集并分析患者的基线人口统计学资料、下肢深静脉血栓形成（LEDVT）表现、血栓特征、同时发生的肺栓塞、合并症和 LEDVT 的相关危险因素，以及 IVCT 和 VCF 相关信息。采用单变量分析和多变量分析评估比值比（OR）及其 95%置信区间（CI）。
共纳入 117 例符合条件的患者，CT 静脉造影图像上识别出 VCF 支撑柱周围的区域性孤立充盈缺损，与下腔静脉（IVC）壁接触，IVC 前壁和/或小轴侧发现血栓的频率更高。单变量分析提示，IVCT 原位的发生率（31.6%，37/117）与年龄（P=0.001）、血栓侧（左侧（P=0.001）和双侧（P=0.001））、高血压（P=0.008）、滤器形状（P<0.001）、IVC 短轴直径（P=0.009）或放大百分比（P=0.004）、IVC 长轴直径（P=0.006）有关。多变量分析提示，双侧 LEDVT（OR，4.92；95%CI，1.56-15.51；P=0.007）和 IVC 短轴放大百分比增加（OR，1.01；95%CI，1.00-1.03；P=0.013）是 IVCT 原位的统计学显著风险因素，而年龄增加（OR，0.96；95%CI，0.94-0.99；P=0.013）和 IVC 短轴直径减小（OR，0.87；95%CI，0.77-0.98；P=0.026）与 IVCT 原位的发生几率降低有关。
IVCT 原位表现为 VCF 与 IVC 壁接触点的区域性孤立充盈缺损。双侧 LEDVT 和 IVC 短轴放大百分比增加可能是影响 IVCT 原位发生的潜在危险因素，而年龄增加和 IVC 短轴直径减小则可能降低 IVCT 原位的发生率，似乎是 IVCT 原位发生的保护因素。
