Greenfield L J, Proctor M C, Cho K J, Cutler B S, Ferris E J, McFarland D, Sobel M, Tisnado J
Department of Surgery, University of Michigan, Ann Arbor.
J Vasc Surg. 1994 Sep;20(3):458-64; discussion 464-5. doi: 10.1016/0741-5214(94)90146-5.
The purpose of this study was to evaluate the long-term safety and efficacy of the titanium Greenfield filter-modified hook for prevention of pulmonary embolism.
We conducted a prospective study in 173 patients from four institutions who underwent clinical examination, abdominal radiography, and duplex ultrasound examinations of the vena cava and lower extremities. If indicated by protocol or clinical presentation, computed tomography scans, pulmonary angiograms, or venacavograms were obtained.
The most common procedural event was filter limb asymmetry (10%), which had no clinical significance. A variety of other minor procedural events occurred in another 10% of cases. Early follow-up (< 6 months) was completed in 149 patients, and long-term evaluation was completed in 113 (> 12 months). Deaths in 24 patients were from nonembolic causes in all but one. There were four suspected or confirmed recurrent pulmonary emboli, for an incidence of 3.5% (four of 113), with one death (0.9%). Four patients had inferior vena cava occlusion at early follow-up and at long-term evaluation, only one remained occluded (1%). Insertion site venous thrombosis was seen in only two patients (2%).
The titanium Greenfield filter provides protection comparable to the standard stainless steel Greenfield filter after 1 year with a low incidence of recurrent pulmonary embolism (3.5%) and a high caval patency rate (99%).
本研究旨在评估钛制格林菲尔德滤器改良钩预防肺栓塞的长期安全性和有效性。
我们对来自四个机构的173例患者进行了一项前瞻性研究，这些患者接受了临床检查、腹部X线摄影以及腔静脉和下肢的双功超声检查。如果方案或临床表现表明需要，还进行了计算机断层扫描、肺血管造影或腔静脉造影。
最常见的操作相关事件是滤器支脚不对称（10%），无临床意义。另外10%的病例发生了各种其他轻微的操作相关事件。149例患者完成了早期随访（<6个月），113例患者（>12个月）完成了长期评估。24例患者的死亡除1例外均由非栓塞原因导致。有4例疑似或确诊的复发性肺栓塞，发生率为3.5%（113例中的4例），其中1例死亡（0.9%）。4例患者在早期随访时出现下腔静脉闭塞，长期评估时仅1例仍处于闭塞状态（1%）。仅2例患者（2%）出现插入部位静脉血栓形成。
钛制格林菲尔德滤器在1年后提供的保护与标准不锈钢格林菲尔德滤器相当，复发性肺栓塞发生率低（3.5%），腔静脉通畅率高（99%）。
