下腔静脉滤器植入术67例临床分析

Clinical Application of Inferior Vena Cava Filters(A Report of 67 Cases)

目的探讨下腔静脉滤器(inferior vena cava filter,IVCF)在下肢深静脉血栓形成中预防肺栓塞的应用。方法回顾性分析67例为预防肺栓塞放置下腔静脉滤器的临床资料。结果本组65例一次植入成功1,例因血管变异改变植入入路后成功,1例因下腔静脉血栓形成放弃植入。37例(55.2%)为永久性滤器植入3,0例(43.3%)为临时性滤器植入。永久性滤器患者随访32例,平均时间14.5(6～32)个月。8例患者出现不同程度近心端移位,其中1例移位显著予取出。所有放置滤器患者均无继发PE发生。未发现腔静脉继发性血栓形成。结论腔静脉滤器植入是预防肺栓塞安全、有效的方法,存在一定并发症发生风险。应尽可能留置临时性滤器以降低远期并发症发生。

Objective To evaluate the value of clinical application of inferior vena cava filter （IVCF） placement for deep vein thrombosis （DVT）and its complication prevention. Methods Sixty-seven cases underwent percutaneous placement of IVCF for prevention of pulmonary embolism （ PE ）, in whom 37 patients （55.2%）were implanted permanent IVCF, 29 cases （43.3%）were implanted provisional IVCF and 1 case was not implanted the ICVF. The clinical data were reviewed retrospectively. Results The filters were placed successfully in 65cases. In 1 case the pathway was changed due to anatomic variation and in another case the operation aborted due to inferior vena cava thrombosis. 32 cases of permanent IVCF were followed up for 6 to 32 months （ 14.5 months in average）. The permanent filter moved proximally in 8 cases. No consequential PE or inferior vena cava thrombosis was observed during follow-up. Conclusion The IVCF placement is an effective and safe technique in PE prevention. However complications may happen in some cases and the temporary IVCF should be adopted as a priority.