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[使用先进技术导致下腔静脉滤器取出失败的因素:一项单中心研究]

[Factors Contributing to Inferior Vena Cava Filter Removal Failure using Advanced Techniques: A Single-Center Study].

作者信息

Cho Hyeong Ryun, Han Young Min, Hwang Hong Pil

出版信息

J Korean Soc Radiol. 2025 Jan;86(1):105-113. doi: 10.3348/jksr.2024.0046. Epub 2025 Jan 16.

Abstract

PURPOSE

To investigate the factors contributing to inferior vena cava (IVC) filter removal failure by comparing successful and failed cases using advanced techniques.

MATERIALS AND METHODS

IVC filter removal was attempted in 331 patients. Of the 29 patients in whom IVC filter removal failed using a simple technique, the IVC filter was successfully removed using an advanced technique in 18 patients and failure was noted in 11 patients. Age, sex, filter type, indwelling period, IVC diameter, tilting angle between the IVC and the filter, IVC wall penetration of the filter strut, and whether the filter was embedded or endothelialized within the IVC wall were compared in each group.

RESULTS

Overall, there were 13 men (72%) in the success group and 3 men (27%) in the failure group; more women were present in the failure group ( = 0.027). Unlike in the success group, hook embedment (9/11, 82%) or IVC filter endothelialization (2/11, 18%) within the wall of the IVC were observed in the failure group using two-dimensional venography.

CONCLUSION

When using advanced techniques for IVC filter removal, females are at a higher risk of failure compared to males. Hook embedment and IVC filter endothelialization within the IVC wall, rather than penetration of the IVC wall, are crucial factors in failure of IVC filter removal using advanced techniques.

摘要

目的

通过使用先进技术比较成功和失败的病例,研究导致下腔静脉(IVC)滤器取出失败的因素。

材料与方法

对331例患者尝试进行IVC滤器取出术。在29例使用简单技术取出IVC滤器失败的患者中,18例使用先进技术成功取出IVC滤器,11例取出失败。比较每组患者的年龄、性别、滤器类型、留置时间、IVC直径、IVC与滤器之间的倾斜角度、滤器支柱对IVC壁的穿透情况,以及滤器是否嵌入IVC壁或在IVC壁内发生内皮化。

结果

总体而言,成功组有13名男性(72%),失败组有3名男性(27%);失败组女性更多(P = 0.027)。与成功组不同,在失败组中,使用二维静脉造影观察到IVC壁内有钩状嵌入(9/11,82%)或IVC滤器内皮化(2/11,18%)。

结论

在使用先进技术进行IVC滤器取出时,女性比男性失败风险更高。IVC壁内的钩状嵌入和IVC滤器内皮化,而非IVC壁穿透,是使用先进技术取出IVC滤器失败的关键因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9c8/11822287/3fd568f02b59/jksr-86-105-g001.jpg

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