Loop技术矫转法对复杂性下腔静脉滤器取出的技巧及应用效果分析

Application of “rotation-correction loop technique” in the retrieval of complex inferior vena cava filters

目的在临床实践过程中,我们发明了loop技术矫转法应用于复杂性下腔静脉滤器的取出,本文探讨该技术应用的技巧和优势。方法 回顾2022年1月至2022年12月于山西医科大学第二医院血管外科行下腔静脉滤器取出的417例患者的临床资料。以手术时间和术中辐射量为评判指标,比较标准滤器取出术、loop技术矫转法和loop配合其他技术的优劣。结果 Loop技术矫转法术中辐射剂量及手术时长均显著低于loop联合其他辅助技术(P<0.000 1)。结论 Loop技术矫转法对于复杂性下腔静脉滤器的取出,尤其是严重倾斜、回收钩贴壁的滤器,可缩短手术时间,降低手术辐射剂量,有较高的安全性和实用性,器械简单、可单人操作,利于开展,值得推广。

Objective To discuss the application of the “rotating guidewire and correcting the filter recovery hook direction technique” (“rotation-correction loop technique” for short), a technique invented by the authors in clinical practice, in the retrieval of complex inferior vena cava filter(IVCF), and to discuss its technical skills and advantages. Methods The clinical data of 417 patients carrying an IVCF, who were admitted to the Department of Vascular Surgery of Second Hospital of Shanxi Medical University of China to retrieve IVCF between January 2022 and December 2022, were retrospectively analyzed. Taking the time spent on the retrieval of IVCF and the intraoperative radiation dose as the evaluation indicators, the advantages and disadvantages of the standard filter retrieval technique, the “rotation-correction loop technique” and the other loop-assisted techniques were compared. Results Both the intraoperative radiation dose and the time spent on the retrieval of IVCF using “rotation-correction loop technique” were remarkably lower than those of other loop-assisted techniques(P<0.000 1). Conclusion For the retrieval of complex IVCF, especially for the IVCF which is heavily tilted and/or its recovered hook is attached to the vascular wall, the use of “rotationcorrection loop technique” can shorten the time spent on the the retrieval of IVCF and reduce the intraoperative radiation dose. This technique carries high safety and practicability, the device is simple and it can be manipulated by single physician, which is conducive to clinical application and promotion.