Wojtowycz M M, Stoehr T, Crummy A B, McDermott J C, Sproat I A
Department of Radiology, University of Wisconsin-Madison 53792, USA.
J Vasc Interv Radiol. 1997 Mar-Apr;8(2):171-9. doi: 10.1016/s1051-0443(97)70535-9.
To examine a large single-center experience with Bird's Nest vena caval filters for indications, clinically evident recurrent thromboembolic disease, and other filter-related complications.
During a 6-year period, 308 patients underwent percutaneous placement of an inferior vena caval filter. The 267 patients who received a Bird's Nest filter are the subject of this retrospective review. The series included 162 men and 105 women who ranged in age from 16 to 88 years (mean, 57.1 +/- 17.0 standard deviation).
Indications for filter placement included contraindication to anticoagulation (n = 141), complication of anticoagulation (n = 23), failure of anticoagulation (n = 30), failure of previously placed filter (n = 1), and prophylaxis (n = 82). Ten patients had more than one indication. Acute lower extremity deep venous thrombosis was confirmed in 133 patients, pulmonary embolism (PE) was found in 44 patients, and both were positively diagnosed in 37 other patients. Fifty-three patients had no documented acute thromboembolic disease at the time of insertion. Mean follow-up was 13 months. Thirty-day mortality was 9.7%, including one death from recurrent PE and one major puncture-site bleeding episode that may have contributed to death. Recurrent PE was found at radionuclide scanning or autopsy in three patients (1.1%), whereas another eight patients (3.0%) had suspected recurrent PE without confirmatory studies. Eight patients (3.0%) developed early venous access site thrombosis, including two who progressed to phlegmasia cerulea dolens with fatal complications. Significant nonthromboembolic problems were encountered in 1.9% of patients.
The Bird's Nest filter is a safe and effective device for patients with complicated venous thromboembolic disease.
探讨使用鸟巢式腔静脉滤器的大型单中心经验，包括其适应证、临床明显的复发性血栓栓塞性疾病以及其他与滤器相关的并发症。
在6年期间，308例患者接受了经皮置入下腔静脉滤器。本回顾性研究的对象是267例接受鸟巢式滤器的患者。该系列包括162例男性和105例女性，年龄范围为16至88岁（平均57.1±17.0标准差）。
滤器置入的适应证包括抗凝禁忌证（n = 141）、抗凝并发症（n = 23）、抗凝失败（n = 30）、先前置入滤器失败（n = 1）以及预防（n = 82）。10例患者有不止一项适应证。133例患者确诊为急性下肢深静脉血栓形成，44例患者发现肺栓塞（PE），另有37例患者两者均被阳性诊断。53例患者在置入时无记录的急性血栓栓塞性疾病。平均随访时间为13个月。30天死亡率为9.7%，包括1例死于复发性PE和1例可能导致死亡的严重穿刺部位出血事件。3例患者（1.1%）在放射性核素扫描或尸检时发现复发性PE，而另外8例患者（3.0%）疑似复发性PE但未经证实。8例患者（3.0%）发生早期静脉入路部位血栓形成，其中2例进展为股青肿并伴有致命并发症。1.9%的患者出现了严重的非血栓栓塞性问题。
对于患有复杂静脉血栓栓塞性疾病的患者，鸟巢式滤器是一种安全有效的装置。
