Millward S F, Bormanis J, Burbridge B E, Markman S J, Peterson R A
Department of Radiological Sciences, Ottawa Civic Hospital, Ontario, Canada.
J Vasc Interv Radiol. 1994 Nov-Dec;5(6):863-8. doi: 10.1016/s1051-0443(94)71626-2.
The authors describe their preliminary clinical experience with the Gunther temporary inferior vena cava (IVC) filter.
Seven women and 10 men, mean age 52 years (range, 19-85 years), were treated with the temporary IVC filter. Indications for filter placement were pulmonary embolism (PE) in four patients and iliofemoral deep venous thrombosis in six. In these patients anticoagulation was contraindicated because of planned major surgery. Filters were placed in four patients following massive PE and in three for prophylaxis following cranial trauma. Four patients had underlying malignant disease. Filters were introduced through the right common femoral vein in 14 patients, the left common femoral vein in two, and the left internal jugular vein in one.
No patient developed recurrent PE with the filter in place. All filters were removed without complication 3-14 days (mean, 7 days) after placement. Two of the patients with underlying malignant disease required placement of a permanent filter. Two patients developed IVC thrombosis with the filter in place, and both developed recurrent PE after filter removal. Two patients developed insertion vein thrombosis. One patient developed a bleeding disorder that caused a massive hematoma at the insertion vein site, which may have contributed to her death.
The Gunther temporary filter can be used in selected patients; however, patients with underlying malignant disease may be more appropriately treated with a permanent filter. The temporary filter does not appear to reduce the rate of insertion vein and IVC thrombosis.
作者描述了他们使用冈瑟临时下腔静脉(IVC)滤器的初步临床经验。
17例患者,其中7名女性,10名男性,平均年龄52岁(范围19 - 85岁),接受了临时IVC滤器治疗。放置滤器的指征为4例肺栓塞(PE)和6例髂股深静脉血栓形成。这些患者因计划进行大手术而抗凝治疗禁忌。4例患者在大面积PE后放置滤器,3例在颅脑外伤后用于预防。4例患者有潜在恶性疾病。14例患者通过右股总静脉置入滤器,2例通过左股总静脉,1例通过左颈内静脉。
滤器在位期间无患者发生复发性PE。所有滤器在放置后3 - 14天(平均7天)均顺利取出,无并发症。2例有潜在恶性疾病的患者需要放置永久性滤器。2例患者滤器在位时发生IVC血栓形成,且均在滤器取出后发生复发性PE。2例患者发生置入静脉血栓形成。1例患者发生出血性疾病,在置入静脉部位形成巨大血肿,这可能是导致其死亡的原因。
冈瑟临时滤器可用于特定患者;然而,有潜在恶性疾病的患者可能更适合使用永久性滤器。临时滤器似乎并未降低置入静脉和IVC血栓形成的发生率。