9Fr长鞘配合记忆合金圈套器回收下腔静脉滤器的效果观察

Inferior vena cava filter retrieval using 9Fr long sheath in combination with memory alloy loop snare

目的探讨9Fr长鞘配合记忆合金圈套器回收Cook下腔静脉滤器的临床效果。方法回顾性分析按计划实施Cook下腔静脉滤器回收的51例中央型下肢深静脉血栓患者临床资料,均因接受血栓清除手术而植入下腔静脉滤器。其中回收时采用Cook MReye滤器回收系统者20例(常规回收技术组),9Fr长鞘配合记忆合金圈套器者31例(长鞘+圈套器组)。观察并比较两组患者滤器存体时间、手术时间、术中射线暴露时间、滤器回收成功率、住院时间、住院费用、术中及术后不良事件发生率等指标。结果长鞘+圈套器组与常规回收技术组滤器回收成功率比较,差异无统计学意义(P>0.05)。长鞘+圈套器组手术时间、术中射线暴露时间、住院费用均低于常规回收技术组,差异均有统计学意义(均P<0.05);两组患者滤器存体时间、住院时间比较,差异均无统计学意义(均P>0.05)。术中及术后均未发生滤器回收失败,下腔静脉破裂、残余狭窄或附壁血栓,穿刺部位并发症、肺动脉栓塞等严重不良事件。结论 9Fr长鞘配合记忆合金型圈套器回收下腔静脉滤器是一种安全、有效、经济的方法,可在临床推广应用。

Objective To evaluate the efficacy and safety of 9Fr long sheath in combination with memory alloy loop snare in retrieval of inferior vena cava filter(Cook). Methods The clinical data of 51 patients, who underwent planned inferior vena cava filter(Cook) retrieval after thrombus removal for central deep venous thrombosis(DVT), were retrospectively analyzed. In 20 cases, the filter was retrieved with Cook MReye retrieval system(standard technique group) and in 31 cased with 9Fr long sheath combined with memory alloy loop snare(combination group). Demographics, filter indwell time, procedure duration, X-ray exposure time, technique success rate, length of hospital stay, costs, peri-and post-procedure adverse events were compared between the 2 groups. Results The procedure duration, X-ray exposure time and costs of the combination group were significantly decreased compared with the standard technique group(P<0.05). There were no statistically significant differences in technique success rate, filter indwell time and length of hospital stay between the two groups(P >0.05). No major adverse events were observed in both groups, including retrieval failure, vena cava rupture, residual stenosis or mural thrombosis, puncture site complications, and pulmonary artery embolism(PE) occurred during and after the procedure. Conclusion 9Fr long sheath in combination with memory alloy snare technique is safe, effective and cost-effective for inferior vena cava filter(Cook) retrieval.