常见下腔静脉滤过器的临床应用

Clinical Applications of Commonly Used Inferior Vena Cava Filters

目的 比较几种常见下腔静脉滤过器 (IVCF)的特性 ,明确各自的适应证。资料与方法 总结 86例 90只IVCF的应用经验 ,其中临时性滤过器ATF 2 0只 ,LGT TF 4只 ;永久性滤过器GF 1 3只 ,BNF 8只 ,SNF 1 5只 ,TEF 1 8只 ,LGM VTF 6只 ,临时、永久两用滤过器GTF 6只。对它们的材料、形状、适用下腔静脉形态、置入途径等进行比较 ,置入后造影、评价 ,跟踪随访其滤过效果、形态、位置及下腔静脉通畅程度。结果 4只临时性滤过器附有大量血栓 ,改作永久性滤过器置入术。综合评价优、良、一般的 87只滤过器置入后未发生肺栓塞症状 ,评价差的 3只中有 1例于 1 6h后突发广泛性肺栓塞死亡。结论 临时性滤过器适用于急性血栓和外科、介入手术前。永久性滤过器宜根据下腔静脉的形态。

Objective To compare the features of several commonly used inferior vena cava filters, and to further define the practical indications of each filter.Materials and Methods The experience of applying 90 inferior vena cava filters in 86 patients was summarized. The temporal filters included Antheor temporal filter (ATF, n=20) and LGT temporal filter (LGT TF, n=4). The permanent filters included Greenfield filter (GF, n=13), bird's nest filter (BNF, n=8), Simon nitinol filter (SNF, n=15), LGM-Vena Tech filter (n=6) and Gunther Tulip filter (n=6). The filter's materials, figures, suitability for the IVC shape, and the access site were compared with each other. The clinical effect, shape and position of the inserted filters, as well as the patency of IVC after the procedure were evaluated and followed up with angiography.Results Large amounts of thrombosis adhered to the inserted filters was seen in 4 temporal filters, which were replaced with permanent ones. Excellent, good and ordinary results were obtained in 83 IVC filters, in which no pulmonary thromboembolism occurred. Of 3 patients with poor results, sudden death from extensive pulmonary thromboembolism occurred in one 16 hours after the procedure.Conclusion The temporal filters are suitable for the treatment of acute thrombosis, and used as the preparation before surgery or interventional procedures, while the permanent filters should be selectly used according to the shape and size of the IVC.