Peng Tao, Li Dan, Wu Ke-Tong, Liu Yang, Lai Hai-Yang, Wan Yuan, Zhang Bo
Department of General Surgery (Intervention Department), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Phlebology. 2025 Sep 18:2683555251380913. doi: 10.1177/02683555251380913.
ObjectiveIn patients with occlusion or severe stenosis of the internal jugular vein, the retrieval of temporary inferior vena cava (IVC) filters often proves technically challenging. This study was designed to evaluate the feasibility and safety of the right subclavian vein (SCV) as an alternative access route for retrieving temporary IVC filters.MethodsPatients treated with inferior vena cava (IVC) filters were included in a retrospective analysis between August 2023 and May 2025. A total of 87 eligible patients were divided into two separate groups based on the puncture route; right subclavian vein (SCV) group and internal jugular vein (IJV) group. A retrospective analysis was performed on their patient demographics, operative duration, radiation dose, costs, and postoperative recovery time.ResultsNotable statistical disparities were detected between the two groups in primary disease, operative time, fluoroscopy time, and radiation dose. Compared with the internal jugular vein (IJV) group, the right subclavian vein (SCV) group exhibited a higher prevalence of primary malignant diseases, along with a mean 7.35-min increase in operative time, 127-s longer fluoroscopy time, and 14.11-mGy higher radiation dose. Follow-up CT assessments revealed sustained patency of the subclavian veins in the right subclavian vein (SCV) group, with no instances of thrombosis or stenosis observed during the postoperative period, or any life-threatening pneumothorax or bleeding was detected.ConclusionsThe right subclavian vein (SCV) approach is suggested as a safe and effective alternative, especially when the internal jugular vein (IJV) is severely stenosed or occluded. For temporary inferior vena cava (IVC) filter retrieval, the conventional internal jugular vein (IJV) route is recommended; however, the right subclavian vein (SCV) may be considered a clinically appropriate alternative in specific indications, without significantly increasing procedural difficulty or surgical costs.
目的
对于颈内静脉闭塞或严重狭窄的患者，取出临时下腔静脉滤器在技术上往往具有挑战性。本研究旨在评估右锁骨下静脉作为取出临时下腔静脉滤器的替代入路的可行性和安全性。
方法
纳入2023年8月至2025年5月期间接受下腔静脉滤器治疗的患者进行回顾性分析。根据穿刺途径将87例符合条件的患者分为两组：右锁骨下静脉组和颈内静脉组。对两组患者的人口统计学资料、手术时间、辐射剂量、费用和术后恢复时间进行回顾性分析。
结果
两组在原发疾病、手术时间、透视时间和辐射剂量方面存在显著统计学差异。与颈内静脉组相比，右锁骨下静脉组原发性恶性疾病的患病率更高，手术时间平均增加7.35分钟，透视时间延长127秒，辐射剂量高14.11毫戈瑞。随访CT评估显示右锁骨下静脉组锁骨下静脉持续通畅，术后未观察到血栓形成或狭窄情况，也未检测到任何危及生命的气胸或出血。
结论
建议将右锁骨下静脉入路作为一种安全有效的替代方法，尤其是在颈内静脉严重狭窄或闭塞时。对于取出临时下腔静脉滤器，推荐采用传统的颈内静脉途径；然而，在特定适应证下，右锁骨下静脉可被视为临床上合适的替代方法，且不会显著增加操作难度或手术费用。
