Vos L D, Tielbeek A V, Bom E P, Gooszen H C, Vroegindeweij D
Department of Radiology, Catharina Hospital, Michelangelolaan 2, NL-5623 EJ Eindhoven, The Netherlands.
Cardiovasc Intervent Radiol. 1997 Mar-Apr;20(2):91-7. doi: 10.1007/s002709900113.
To evaluate clinically the Günther temporary inferior vena cava (IVC) filter.
Eleven IVC filters were placed in 10 patients. Indications for filter placement were surgical pulmonary embolectomy in seven patients, pulmonary embolism in two patients, and free-floating iliofemoral thrombus in one patient. Eight filters were inserted from the right femoral approach, three filters from the left. Follow-up was by plain abdominal radiographs, cavography, and duplex ultrasound (US). Eight patients received systemic heparinization. Follow-up, during 4-60 months after filter removal was by clinical assessment, and imaging of the lungs was performed when pulmonary embolism (PE) was suspected. Patients received anticoagulation therapy for at least 6 months.
Ten filters were removed without complications 7-14 days (mean 10 days) after placement. One restless patient pulled the filter back into the common femoral vein, and a permanent filter was placed. In two patients a permanent filter was placed prior to removal. One patient developed sepsis, and one an infection at the insertion site. Clinically no recurrent PE developed with the filter in place or during removal. One patient had recurrent PE 7 months after filter removal.
The Günther temporary IVC filter can be safely placed for short-term protection against PE. The use of this filter is not appropriate in agitated or immunocompromised patients.
对京特临时下腔静脉(IVC)滤器进行临床评估。
在10例患者中放置了11个IVC滤器。放置滤器的指征为7例患者行外科肺动脉栓子切除术,2例患者为肺栓塞,1例患者为游离性髂股静脉血栓。8个滤器经右股静脉途径插入,3个滤器经左股静脉途径插入。通过腹部平片、腔静脉造影和双功超声(US)进行随访。8例患者接受了全身肝素化治疗。在取出滤器后4 - 60个月期间,通过临床评估进行随访,当怀疑有肺栓塞(PE)时对肺部进行影像学检查。患者接受至少6个月的抗凝治疗。
10个滤器在放置后7 - 14天(平均10天)顺利取出,无并发症。1例躁动患者将滤器拉回股总静脉,随后放置了永久性滤器。2例患者在取出滤器前放置了永久性滤器。1例患者发生脓毒症,1例患者在插入部位发生感染。临床上,在滤器在位期间或取出过程中均未发生复发性PE。1例患者在滤器取出后7个月发生复发性PE。
京特临时IVC滤器可安全放置以短期预防PE。该滤器不适用于躁动或免疫功能低下的患者。