Denali和Celect下腔静脉滤器回收单中心经验

The retrieval of Denali and Celect inferior vena cava filters:a single center experience

目的对比分析Denali和Celect可回收下腔静脉滤器回收的难易程度和手术相关并发症。方法收集2015年6月至2019年6月在北京世纪坛医院接受Denali或Celect可回收下腔静脉滤器置入的196例患者临床资料,其中Denali组101例,Celect组95例。分析两组一般资料、回收过程及相关并发症情况。结果患者一般资料差异无统计学意义,具可比性。Denali组、Celect组分别有87例(86.1%)、75例(78.9%)尝试回收,回收成功率分别为98.9%(86/87)、97.3%(73/75)(P>0.05)。Denali组滤器留置时间显著长于Celect组[(95.8±44.5)d对(73.6±38.2)d,P=0.001]。Celect组有更多患者需结合其他技术取出,通常更多需通过颈部和腹股沟入路双向进行,相应手术时间、手术费用均显著高于Denali组[(67.2±17.8)min对(58.5±18.9)min,P=0.003;(15539.4±6082.6)元对(13127.5±3252.6)元,P=0.002],但对比剂用量未明显增加。CT评价显示Celect组倾斜、穿透发生率均较高(P<0.001)。结论Denali滤器相对Celect滤器体内留置时间更长,取出时需应用额外回收技术概率较小,滤器倾斜和穿透并发症发生率较低。

Objective To compare the manipulation complexity and operation-related complications of retrieval of Denali retrievable inferior vena cava(IVC)filters with those of Celect retrievable IVC filters.Methods The clinical data of a total of 196 patients,who received implantation of Denali or Celect retrievable IVC filter at the Beijing Shijitan Hospital of China during the period from June 2015 to June 2019,were retrospectively analyzed.The patients were divided into Denali group(n=101)and Celect group(n=95).The general information,the process of filter retrieval and the procedure-related complications of both groups were analyzed.Results No statistically significant differences in patients’general information existed between the two groups.In Denali group and Celect group,retrieval of IVC filters was tried in 87 patients(86.1%)and 75 patients(78.9%)respectively,and the success rate of filter retrieval was 98.9%(86/87)and97.3%(73/75)respectively(P>0.05).The mean retention time of filter in Denali group was(95.8±44.5)days,which was remarkably longer than(73.6±38.2)days in Celect group(P=0.001).The number of patients,in whom the filter retrieval needed additional help of other techniques such as two-way approach method through simultaneously via the cervical access and femoral access,was more than that in Denali group.The mean time spent for operation and the mean surgical expense in Celect group were(67.2±17.8)min and(15539.4±6082.6)Chinese Yuan respectively,which were strikingly higher than(58.5±18.9)min and(13127.5±3252.6)Chinese Yuan respectively in Denali group(P=0.003 and P=0.002,respectively).The used dose of contrast agent in Celect group was not obviously increased.CT scan evaluation showed that in Celect group the incidence of tilting and penetration of filters was much higher(P<0.001).Conclusion Compared with Celect filters,Denali filters usually retain in IVC for longer time,the retrieval of Denali filters requires less additional techniques,and the incidence of tilting and penetration of Denali filters is low.(J Intervent Radiol,2021,30:989-993)