Sung Eric, Ramirez Joel L, Zarkowsky Devin
Division of Vascular and Endovascular Surgery, Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA.
J Vasc Surg Cases Innov Tech. 2024 Feb 14;10(3):101445. doi: 10.1016/j.jvscit.2024.101445. eCollection 2024 Jun.
More than 10 million cases of venous thromboembolisms are reported on an annual basis and are major contributors to morbidity and mortality. Studies have found that ≤90% of pulmonary embolisms originate from the abdominal and lower extremity veins. The mainstay of venous thromboembolism treatment has been, and still continues to be, anticoagulation. However, for patients for whom anticoagulation is contraindicated or has failed, physicians have turned to surgical innovations such as inferior vena cava (IVC) filters to create partial interruption of the IVC. Before the invention of IVC filters, the Adams-DeWeese clip was developed to create caval interruption, which allowed for venous return while preventing pulmonary emboli from distal veins. We report a case of endovascular release of a long-term Adams-DeWeese clip, which had caused IVC occlusion and debilitating bilateral lower extremity swelling.
每年报告的静脉血栓栓塞病例超过1000万,是发病和死亡的主要原因。研究发现,≤90%的肺栓塞起源于腹部和下肢静脉。静脉血栓栓塞治疗的主要方法一直是且仍然是抗凝治疗。然而,对于抗凝治疗禁忌或失败的患者,医生已转向诸如下腔静脉(IVC)滤器等手术创新方法,以部分中断下腔静脉。在IVC滤器发明之前,Adams-DeWeese夹被开发用于造成腔静脉中断,在防止远端静脉肺栓塞的同时允许静脉回流。我们报告了一例长期植入的Adams-DeWeese夹血管内释放的病例,该夹子导致了下腔静脉阻塞和双侧下肢严重肿胀。