Poletti P A, Becker C D, Prina L, Ruijs P, Bounameaux H, Didier D, Schneider P A, Terrier F
Department of Radiology, Division of Diagnostic and Interventional Radiology, Geneva University Hospital, 24 Rue Micheli-du Crest, CH-1211 Geneva 14, Switzerland.
Eur Radiol. 1998;8(2):289-94. doi: 10.1007/s003300050382.
The aim of this study was to evaluate the clinical efficacy, mechanical stability, and safety of the Simon nitinol inferior vena cava filter (SNF). The SNF was inserted in 114 consecutive patients at two institutions for prophylaxis of pulmonary embolism (PE). Clinical follow-up data were obtained retrospectively on all patients, and 38 patients underwent a dedicated radiologic follow-up protocol consisting of abdominal radiography, Doppler sonography, and CT. There was no immediate complication following filter insertion. Fifty patients died, on average, 5.6 (1-23) months after filter insertion, and 64 patients were alive, on average, 27 (3-62) months after filter insertion. Recurrent pulmonary embolism was documented in 5 patients (4.4 %) but originated distal to the filter in 1 patient. Deep venous thrombosis (DVT) was documented in 5.3 %, thrombosis at the access site in 3.5 %, and thrombosis of the inferior vena cava in 3.5 %. The rate of thromboembolic complications was similar in patients who did receive long-term anticoagulation and in those who did not. Radiologic follow-up showed no filter migration after, on average, 32 (5-62) months. A CT examination showed that struts of the SNF had penetrated the vena cava in 95 %, and were in contact with adjacent organs in 76 %; however, there were no clinical symptoms attributable to the filter. Filters were in an eccentric position in 63 % and partial filter disruption was found in 16 %; however, this did not affect filter function. The rate of recurrent pulmonary embolism after insertion of the SNF is 2.4 % per patient per year. Regardless of long-term anticoagulation, the rate of caval thrombosis is acceptably low. Except for occasional access-site thrombosis, no other filter-related morbidity was observed.
本研究旨在评估西蒙镍钛诺下腔静脉滤器（SNF）的临床疗效、机械稳定性和安全性。在两家机构对114例连续患者植入SNF以预防肺栓塞（PE）。对所有患者进行了回顾性临床随访，38例患者接受了包括腹部X线摄影、多普勒超声和CT的专门影像学随访方案。滤器植入后无即刻并发症。50例患者在滤器植入后平均5.6（1 - 23）个月死亡，64例患者在滤器植入后平均27（3 - 62）个月存活。5例患者（4.4%）记录到复发性肺栓塞，但1例患者的复发性肺栓塞起源于滤器远端。记录到深静脉血栓形成（DVT）的发生率为5.3%，穿刺部位血栓形成的发生率为3.5%，下腔静脉血栓形成的发生率为3.5%。接受长期抗凝治疗的患者和未接受长期抗凝治疗的患者血栓栓塞并发症发生率相似。影像学随访显示，平均32（5 - 62）个月后滤器无移位。CT检查显示，95%的SNF支柱穿透了腔静脉，76%与相邻器官接触；然而，没有因滤器导致的临床症状。63%的滤器位置偏心，16%发现滤器部分断裂；但这并未影响滤器功能。SNF植入后患者每年复发性肺栓塞的发生率为2.4%。无论是否进行长期抗凝，腔静脉血栓形成的发生率都低至可接受。除偶尔的穿刺部位血栓形成外，未观察到其他与滤器相关的发病率。
