可调弯鞘在回收困难的伞形下腔静脉滤器取出术中的应用

Application of adjustable curved sheath in extraction of umbrella-shaped inferior vena cava filter with difficult recovery

目的探讨可调弯鞘在回收困难的伞形下腔静脉滤器取出术中的应用价值。方法收集2021年7月至2023年2月于南京中医药大学附属无锡医院就诊的24例滤器回收困难患者临床资料,均采用可调弯鞘进行滤器回收,分析所有患者的手术成功率,观察下腔静脉血流通畅情况、管壁情况、造影剂外溢或滞留情况、滤器情况、相关并发症发生情况。结果23例患者手术成功,1例因患有阿尔茨海默病,术中不能配合而放弃手术。回收滤器均结构完整、无折断,无变形,滤器取出后行下腔静脉造影均未发现造影剂滞留或外渗。手术时间25~120 min,平均58 min,未明显增加手术时间及费用,无相关并发症发生。结论应用可调弯鞘可以显著提高回收钩贴壁的下腔静脉滤器回收成功率,安全、有效,具有一定的临床应用价值。

Objective To investigate the application value of adjustable curved sheath in extraction of umbrellashaped inferior vena cava filter with difficult recovery.Method A total of 24 patients with difficulty in filter recovery were collected from Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine from July 2021 to February 2023.All patients were treated with adjustable curved sheath for filter recovery.The surgical success rate of all patients was analyzed,and the flow of venous blood in the lower cavity,the condition of tube wall,the spill or retention of contrast agent,the condition of filter,and the occurrence of related complications were observed.Result A total of 23 patients were successful during the operation,one patient gave up the surgery due to Alzheimer's disease and could not cooperate during the operation.After removing the filters,no contrast agent retention or extravasation was found during inferior vena cava angiography.The operation time was 25-120 min,with an average of 58 min.There was no significant increase in operation time or cost,and no related complications occurred.Conclusion The application of adjustable bend sheath can significantly improve the success rate of retrieval of IVC filter with hook attachment,which is safe and effective,and has certain clinical application value.