Etienne G, Hevia M, Fond B, Parthenay P, Constantin J M
Unité de Chirurgie Vasculaire, Clinique Saint-Joseph, Angoulême.
J Mal Vasc. 1996;21(5):312-4.
Non-deployment of an L.G.M. percutaneous vena cava filter is rare. The aim of this paper is to report a new case of this complication. A second filter was inserted between the non-deployed filter and the renal veins to prevent proximal migration of the transvenous interruption device to the pulmonary artery or the right side of the heart, and to guarantee an effective prophylaxis of further pulmonary embolization. Two years later, the vena cava was still patent. The best way to avoid this accident is a perfect insertion technique: after a preoperative cavography to check diameter and patency of the vena cava, the filter must be deployed by retracting the introducer sheath while maintaining the position of the inner canula, and not pushing the filter out of the introducer sheath. A second filter must always be available in the operating room in case of incomplete opening of the filter. The use of vena cava filter is not devoid of risks. Restricted indications are therefore recommended.
下腔静脉滤器未成功植入的情况很少见。本文旨在报告这一并发症的一例新病例。在未成功植入的滤器与肾静脉之间插入第二个滤器，以防止经静脉中断装置向肺动脉或心脏右侧近端移位，并确保有效预防进一步的肺栓塞。两年后，下腔静脉仍然通畅。避免这一意外的最佳方法是采用完美的植入技术：术前进行腔静脉造影以检查下腔静脉的直径和通畅情况后，在保持内套管位置的同时，通过回撤导入器鞘来展开滤器，而不是将滤器从导入器鞘中推出。手术室必须始终备有第二个滤器，以防滤器未完全打开。下腔静脉滤器的使用并非没有风险。因此，建议严格掌握适应证。
