Lim M C, Tan H C, Choo M H
Cardiac Department, National University Hospital, Singapore.
Singapore Med J. 1994 Dec;35(6):622-5.
The Greenfield vena cava filter is an established therapeutic option in the prevention of pulmonary embolism. The development of a 12 French modified titanium Greenfield filter (TGF) has made it possible to insert the filter percutaneously and to have a low complication rate. We report our initial experience with percutaneous insertion of the 12-French titanium Greenfield vena cava filter for 6 patients who all had major extensive deep venous thrombosis (DVT) and contraindications to anticoagulation. The inferior vena cava (IVC) filters were inserted in all the 6 patients via the internal jugular route without difficulty. There was no bruising, haematoma or bleeding complications despite the use of the 12 French system. The IVC filter was opened without cross-snaring of the filter legs in all 6 patients. This was confirmed with cranio-caudal, left anterior oblique and right anterior oblique views of the deployed filter. There was however some asymmetry of the filter leg positions but it did not cause any significant angulation of the filter in relation to the IVC. The IVC filters were firmly secured with no filter migration immediately post-procedure. The 12-French titanium Greenfield vena cava filter was safely deployed percutaneously with no complications in our small series of patients. With the use of titanium in the design of Greenfield filter, the clinical effectiveness and performance is maintained while providing for easier insertion and reduction of patient discomfort.(ABSTRACT TRUNCATED AT 250 WORDS)
格林菲尔德腔静脉滤器是预防肺栓塞的一种既定治疗选择。12法式改良钛制格林菲尔德滤器(TGF)的研发使得经皮插入滤器成为可能,且并发症发生率较低。我们报告了对6例患者经皮插入12法式钛制格林菲尔德腔静脉滤器的初步经验,这些患者均患有严重广泛的深静脉血栓形成(DVT)且有抗凝禁忌证。6例患者均经颈内静脉途径顺利插入下腔静脉(IVC)滤器。尽管使用了12法式系统,但未出现瘀伤、血肿或出血并发症。6例患者的IVC滤器均顺利打开,滤器腿未发生交叉圈套。通过展开滤器的头侧-尾侧、左前斜位和右前斜位视图得以证实。然而,滤器腿位置存在一些不对称,但并未导致滤器相对于IVC出现任何明显的成角。术后IVC滤器固定牢固,无滤器移位。在我们这一小系列患者中,12法式钛制格林菲尔德腔静脉滤器经皮安全展开,无并发症发生。在格林菲尔德滤器的设计中使用钛,在保持临床有效性和性能的同时,便于插入并减轻了患者不适。(摘要截短至250字)