Lang W, Weingärtner M, Sturm M, Schweiger H
Abteilung für Gefässchirurgie, Chirurgische Universitätsklinik Erlangen.
Zentralbl Chir. 1994;119(9):625-30.
During a period of 11 years operative placement of a Greenfield vena caval filter was planned in 132 patients. The clinical records of these patients were reviewed retrospectively. Main indications for filter placement were pulmonary embolism in patients with deep venous thrombosis in spite of anticoagulation therapy (45%) and patients with contraindications for anticoagulation (40%). Insertion was successful in 117 patients with a failure rate of 14.6% (21 of 143 procedures). Follow-up data were obtained of all 117 patients with inserted filter (6 of them with 2 filters). Physical examination was performed in 67 of 74 patients alive after a mean postoperative period of 57 months (median: 52.5/range: 1-128). In addition, plain abdominal X-ray was available of all patients. CT scans of the abdomen or venacavography studies were obtained in 60 patients. Major complications as recurrent pulmonary embolism (8%), caval thrombosis (13%), penetrations of struts through the caval wall (33%), tilting of filters (25%), migration (5%) and filter fracture (two cases) were observed. In conclusion, indication should be restricted to certain cases with failure of surgical intervention or drug therapy (thrombectomy, lysis, anticoagulation).
在11年期间，计划对132例患者进行格林菲尔德腔静脉滤器手术植入。对这些患者的临床记录进行了回顾性分析。滤器植入的主要指征是尽管进行了抗凝治疗但仍发生深静脉血栓形成的患者出现肺栓塞（45%）以及有抗凝禁忌证的患者（40%）。117例患者植入成功，失败率为14.6%（143例手术中有21例失败）。获得了所有117例植入滤器患者的随访数据（其中6例植入了2个滤器）。在术后平均57个月（中位数：52.5个月/范围：1 - 128个月）存活的74例患者中，67例进行了体格检查。此外，所有患者均有腹部平片。60例患者进行了腹部CT扫描或腔静脉造影检查。观察到的主要并发症包括复发性肺栓塞（8%）、腔静脉血栓形成（13%）、滤器支柱穿透腔静脉壁（33%）、滤器倾斜（25%）、移位（5%）以及滤器断裂（2例）。总之，适应证应限于手术干预或药物治疗（血栓切除术、溶栓、抗凝）失败的某些病例。
