Kunisch M, Rauber K, Bachmann G, Rau W S
Abteilung Diagnostische Radiologie, Justus-Liebig-Universität Giessen.
Rofo. 1995 Dec;163(6):523-6. doi: 10.1055/s-2007-1016039.
To assess the temporary Günther filter system concerning handling, complication rate and efficacy in respect to prophylaxis of pulmonary embolism.
45 temporary Günther filters were placed in 44 patients (mean age 46 years) with deep venous thrombosis of the iliac and/or inferior vena cava.
The mean time until filter retrieval was 6.1 +/- 4.1 days (maximum 14 days) dependent on the success of either thrombolytic therapy or thrombus consolidation. 27 patients underwent systemic thrombolytic therapy (61%), three patients (7%) received local thrombolysis. 14 patients (32%) were treated with heparin in a therapeutic dosage (PTT > 60 sec). We observed four complications (8.8%): one accidental arterial puncture (carotid artery on attempting an internal jugular vein approach), one infection located at the puncture site and one caval vein thrombosis in a patient with known heparin-associated thrombocytopenia. One patient died of pulmonary embolism despite correct filter positioning.
Percutaneous placement of inferior vena cava filters is therefore an easy, safe and effective prophylaxis in respect of pulmonary embolism if combined with thrombolytic therapy or therapeutic heparinisation.
评估临时 Günther 滤器系统在操作、并发症发生率及预防肺栓塞疗效方面的情况。
44 例（平均年龄 46 岁）患有髂静脉和/或下腔静脉深静脉血栓形成的患者置入了 45 个临时 Günther 滤器。
滤器取出的平均时间为 6.1±4.1 天（最长 14 天），这取决于溶栓治疗或血栓巩固的成功与否。27 例患者接受了全身溶栓治疗（61%），3 例患者（7%）接受了局部溶栓。14 例患者（32%）接受了治疗剂量的肝素治疗（部分凝血活酶时间>60 秒）。我们观察到 4 例并发症（8.8%）：1 例意外动脉穿刺（在尝试颈内静脉穿刺时误穿颈动脉），1 例穿刺部位感染，1 例已知肝素相关性血小板减少症患者发生腔静脉血栓形成。1 例患者尽管滤器位置正确，但仍死于肺栓塞。
因此，经皮置入下腔静脉滤器结合溶栓治疗或治疗性肝素化，在预防肺栓塞方面是一种简便、安全且有效的方法。
