Roehm J O, Thomas J W
Section of Cardiovascular and Interventional Radiology, Methodist Hospital, Baylor College of Medicine, Houston, TX 77030, USA.
J Vasc Interv Radiol. 1995 May-Jun;6(3):455-9. doi: 10.1016/s1051-0443(95)72841-x.
To determine whether a twist technique can help reduce the occurrence of fine-wire prolapse proximal to the hooks of the Bird's Nest filter in the inferior vena cava.
Abdominal radiographs were retrospectively analyzed after placement of filters with no twist (n = 100), with two 360 degree twists (n = 55), or with three 360 degree twists (n = 61).
Prolapse of 5 mm or more was encountered in 32% of cases (32 of 100 cases) in which no twists were imparted. The average length of prolapse was 2.8 cm (range, 0.5-5.1 cm). The average length of the filter nest was 9.4 cm (range 5.1-13.6 cm). Use of two 360 degree twists reduced the rate of prolapse to 9.1% (five of 55 cases) (P < .005 vs no twist); the average length of prolapse was 2.8 cm (range, 0.6-6.4 cm). The average filter-nest length was reduced 7.5 cm (range, 4.0-13.3 cm). With three 360 degree twists, prolapse occurred in 4.9% of cases (three of 61 cases) (P < .005 vs no twist). The average length of prolapse was 2.6 cm (range, 0.7-4.8 cm). The average filter-nest length was 7.8 cm (range, 3.5-12.8 cm). The difference in prolapse frequency when two twists were used as opposed to three is not statistically significant.
Application of two or three 360 degree twists to the catheter-sheath unit during insertion of the Bird's Nest filter produces a statistically significant reduction in the occurrence of wire prolapse.
确定扭转技术是否有助于减少下腔静脉中鸟巢式滤器钩近端细金属丝脱垂的发生。
回顾性分析放置未扭转（n = 100）、两次360度扭转（n = 55）或三次360度扭转（n = 61）滤器后的腹部X线片。
在未进行扭转的100例病例中，32%（32例）出现5mm或更长的脱垂。脱垂的平均长度为2.8cm（范围0.5 - 5.1cm）。滤器巢的平均长度为9.4cm（范围5.1 - 13.6cm）。两次360度扭转使脱垂率降至9.1%（55例中的5例）（与未扭转相比，P < .005）；脱垂的平均长度为2.8cm（范围0.6 - 6.4cm）。滤器巢的平均长度减少至7.5cm（范围4.0 - 13.3cm）。三次360度扭转时，4.9%的病例（61例中的3例）出现脱垂（与未扭转相比，P < .005）。脱垂的平均长度为2.6cm（范围0.7 - 4.8cm）。滤器巢的平均长度为7.8cm（范围3.5 - 12.8cm）。使用两次扭转与三次扭转时脱垂频率的差异无统计学意义。
在插入鸟巢式滤器期间，对导管鞘单元进行两次或三次360度扭转可使金属丝脱垂的发生率在统计学上显著降低。
