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Comparative outcomes of Inferior Vena Cava filters placed at bedside using digital radiography versus conventional fluoroscopy 被引量:3
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作者 John A.Walker Matthew Milam Jorge E.Lopera 《Journal of Interventional Medicine》 2021年第3期139-142,共4页
Purpose:To retrospectively assess the outcomes of Inferior Vena Cava(IVC)filters placed in critically ill patients in the ICU at bedside using digital radiograph(DR)guidance with previous cross-sectional imaging for p... Purpose:To retrospectively assess the outcomes of Inferior Vena Cava(IVC)filters placed in critically ill patients in the ICU at bedside using digital radiograph(DR)guidance with previous cross-sectional imaging for planning,compared to IVC filters placed by conventional fluoroscopy(CF).Method and materials:The cohort consisted of 129 IVC filter placements;48 placed at bedside and 81 placed conventionally from July 2015 to September 2016.Patient demographics,indication,radiation exposures,access site,procedural duration,dwell time,and complications were identified by the EMR.IVC Filter positioning with measurements of tip to renal vein distance and lateral filter tilt were performed when cavograms or post placement CTs were available for review.Statistical analysis was performed using Stata IC 11.2.Results:Technical success of the procedure was 100% in both groups.Procedural duration was longer at the bedside lasting 14.5+/-10.2 versus 6.7+/-6.0 min(p<0.0001).The bedside DR group had a median radiation exposure of 25 mGy(15-35)and the CF group had mean radiation exposure of 256.94 mGy+/-158.6.There was no significant difference in distance of IVC tip to renal vein(p=0.31),mispositioning(p=0.59),degree of filter tilt(p=0.33),or rate of complications(p=0.65)between the two groups.Conclusion:IVCF placement at the bedside using DR is comparable to CF with no statistical difference in outcomes based on IVCF positioning,degree of lateral tilt or removal issues.It decreased radiation dose,but with overall increased procedural time. 展开更多
关键词 Inferior vena cava filters Pulmonary embolism Deep venous thrombosis
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Successful management of infected right iliac pseudoaneurysm caused by penetration of migrated inferior vena cava filter:A case report
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作者 Cheng-Xin Weng Shu-Min Wang +2 位作者 Tie-Hao Wang Ji-Chun Zhao Ding Yuan 《World Journal of Clinical Cases》 SCIE 2021年第30期9211-9217,共7页
BACKGROUND Indwelling inferior vena cava(IVC)filters might cause various complications,including filter penetration,filter fracture,filter migration,and thrombosis of the IVC.Penetration and migration complications ar... BACKGROUND Indwelling inferior vena cava(IVC)filters might cause various complications,including filter penetration,filter fracture,filter migration,and thrombosis of the IVC.Penetration and migration complications are common,while a caudal migrated double-basket filter with associated infected iliac pseudoaneurysm has seldom been reported.CASE SUMMARY We report a 64-year-old female admitted for sudden onset of severe right abdominal pain after IVC filter placement for 3 mo.The patient had a history of failed endovascular IVC filter retrieval.Computed tomography showed that the retrieval hook of the filter penetrated the right common iliac artery and vein,leading to right iliac artery pseudoaneurysm accompanied by right ureteral obstruction with ipsilateral hydronephrosis,and bilateral iliac veins were occluded.Emergency open repair was performed to remove the IVC filter,the right iliac pseudoaneurysm,and the compromised segments of the iliac veins and IVC with right common iliac artery reconstruction.Staphylococcus aureus was isolated from the tissue culture.The patient was discharged on postoperative day 12 with anticoagulation therapy and antibiotic therapy after discharge.Six-month follow-up computed tomography revealed that the right common iliac artery was patent,and only mild hydronephrosis was detected.CONCLUSION An indwelling IVC filter,even‘embedded’within organized thrombus,could still cause life-threatening complications.Open procedures remain the last resort for IVC filters with severe complications. 展开更多
关键词 Inferior vena cava filter Infected pseudoaneurysm HYDRONEPHROSIS filter migration Open repair Antibiotic therapy Case report
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Thrombus Propagation across an Inferior Vena Cava Filter Resulting in Fatal Pulmonary Embolism: A Case Report
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作者 Gordon Offei-Larbi Martin Nartey Tamatey +2 位作者 Mark Mawutor Tettey Isaac Okyere Kwame Adomako 《World Journal of Cardiovascular Surgery》 2022年第10期229-234,共6页
Inferior vena cava (IVC) filters have since been implanted in the 1970s. The aim of implantation is to prevent the occurrence of fatal pulmonary embolism (PE). However, fatal pulmonary embolisms have been occurring af... Inferior vena cava (IVC) filters have since been implanted in the 1970s. The aim of implantation is to prevent the occurrence of fatal pulmonary embolism (PE). However, fatal pulmonary embolisms have been occurring after filter insertion. The mechanism is that either a thrombus or an embolus was already located cranial to the site of deployment of the filter within the inferior vena cava. And so after the filter implantation significant embolism can still occur. We present the case of a 62-year-old woman who had an IVC filter but died two weeks later from pulmonary embolism, through an unusual mechanism. The patient had a fracture of the left tibia, had open reduction and internal fixation developed pulmonary embolism secondary to deep vein thrombosis of the left lower limb. Anticoagulation was started, an IVC filter was inserted and she was discharged home with a therapeutic INR. However, she passed away two weeks later from pulmonary embolism, through the unusual mechanism of thrombus propagation across the IVC filter. The clinical significance of this article is to draw clinicians’ attention to the existence of another mechanism of fatal pulmonary embolism after an IVC filter insertion. The thrombus can propagate across the IVC filter leading to fatal pulmonary embolism. 展开更多
关键词 Inferior vena cava filter Thrombus Propagation Fatal Pulmonary Embolism
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Vena cava thrombosis after vena cava filter placement: Incidence and risk factors 被引量:7
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作者 Ya-Juan Guo Jun Feng Tian-Rong Qu Yan Qu Ya-Min Liu Yu-Shun Zhang Hong-Yan Tian Ai-Qun Ma 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2011年第2期99-103,共5页
这研究的目的是估计静脉 cava 的临床的安全和功效的背景过滤器(VCF ) 放置,与发生和在 VCF 以后的劣等的静脉 cava 血栓(VCT ) 的风险因素上的特别强调放置。有静脉的 thromboembolism (VTE ) 的病人的方法临床的数据,与或没有 VCF ... 这研究的目的是估计静脉 cava 的临床的安全和功效的背景过滤器(VCF ) 放置,与发生和在 VCF 以后的劣等的静脉 cava 血栓(VCT ) 的风险因素上的特别强调放置。有静脉的 thromboembolism (VTE ) 的病人的方法临床的数据,与或没有 VCF 的放置,从 2005 年 1 月在医药记录的回顾的单个中心的审计被分析到 2009 年 6 月。收集了数据包括的人口分布,程序的细节,过滤器类型,指示,和复杂并发症。VTE 的 168 个盒子全部的结果 A (82 与 VCF;86 没有 VCF ) 被检验。在 24.2 个月的中部的后续上, VCT 与 VCF 发生在 82 个病人中的 18 个(11 男性, 7 女性,意味着年龄 55.4 年) 。在没有 VCF 的 86 个病人, VCT 发生在仅仅 6 个个人(4 男性, 2 女性) 在学习时期期间。VCT 在没有 VCF (22% 对 7.0%) ,比在那些与 VCF 适合的病人更经常被观察。在有在 VCF 培植以后的 VTE 的病人的 VCT 的发生近似是 22% 的结论。Anticoagulation 治疗应该与 VCF 放置为所有病人被继续,除非有特定的禁止徵候。在有 VCF 的病人的 VCT 的几乎所有例子在我们的学习植入发生在停止 anticoagulation 治疗以后。VCF 的使用正在增加,并且更多的试用被需要证实他们的利益并且精确地估计他们的安全。 展开更多
关键词 静脉血栓 发病率 过滤器 危险因素 临床安全性 VCT 风险因素 血栓形成
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A first attempt of inferior vena cava filter successfully guided by a mixed-reality system: a case report 被引量:6
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作者 Hang ZHU Yao LI +8 位作者 Chi WANG Qiu-Yang LI Zheng-Yang XU Xin LI Abudureyimu Abudulitipujiang Ji-Xing PAN Er-Long FAN Jun GUO Yun-Dai CHEN 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2019年第7期575-577,共3页
Pulmonary embolism(PE)is one of the fatal heart attacks,and lower limbs deep vein thrombosis(DVT)is the most common reason for PE.Inferior vena cava filter(IVCF)implantation is a most prevention for PE.But it may carr... Pulmonary embolism(PE)is one of the fatal heart attacks,and lower limbs deep vein thrombosis(DVT)is the most common reason for PE.Inferior vena cava filter(IVCF)implantation is a most prevention for PE.But it may carry a high risk of injury because of the radiation and contrast agent.Patients with nephrotic syndrome(NS)or some other renal diseases may prone to thrombosis due to the excretion of protein C and protein S overmuch.So,it is necessary to develop a new therapy without contrast agent.Mixed-reality(MR)is a new technology as a guidance of inferior vena cava filter implantation exposed under no X-ray and required no contrast agent. 展开更多
关键词 INFERIOR vena cava filter Mixed-reality technology PULMONARY EMBOLISM
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Fracture Rate and Serious Complications of Vena Cava Filters 被引量:1
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作者 Myles M. Mitsunaga Hyo-Chun Yoon 《Open Journal of Radiology》 2013年第2期85-90,共6页
Purpose: To retrospectively evaluate the prevalence of fracture and fragment embolization of inferior vena cava (IVC) filters. Methods: Electronic medical records and imaging studies of all Kaiser Permanente patients ... Purpose: To retrospectively evaluate the prevalence of fracture and fragment embolization of inferior vena cava (IVC) filters. Methods: Electronic medical records and imaging studies of all Kaiser Permanente patients who received IVC filters from August 2000 until August 2010 were retrospectively reviewed for filter complications. Results: 283 patients received an IVC filter during the study period. 143 patients were deceased, while 140 are living. Among deceased patients, the average age at the time of death was 69.8 ± 15.3 [range: 24.7 - 99.2] years;55.9% were men;the mean implantation-to-image time was 13.6 ± 20.6 [range: 0 - 92.4] months, and there were no reported major complications attributable to filter migration or fracture at a mean of 16.8 ± 24.8 [range: 0 - 119.6] months following implantation. One of 14 (7.1%) G2 filters perforated the aorta, which already had a stent graft in place. Among those patients still living, the average age was 67.3 ± 15.2 [range: 15.2 - 97.3] years, 47.1% were men, the mean implantation-to-image time was 33.3 ± 36.5 [range: 0.1-141.7] months, and there were no reported major complications at a mean of 35.3 ± 36.5 [range: 0 - 141.7] months following implantation. Three of 60 (5.0%) Trapease filters were found to have at least 1 strut fracture. There were no cases of filter migration or fragment embolization. The overall fracture rate of all filters with an implantation-to-image-time greater than two years (mean implantation-to-image time 4.7 ± 2.7 [range: 2.0 - 11.8] years) was 3 of 67 (4.5%). Bard G2 and G2X filters had a 0% fracture and embolization rate at a mean of 19.0 ± 16.6 [range: 0.07 - 49.5] months after implantation. Conclusions: IVC filters, regardless of type, have a low prevalence of fracture and we found no cases of fragment embolization. 展开更多
关键词 VENOUS THROMBOEMBOLISM INFERIOR vena cava IVC filters Pulmonary EMBOLISM Deep VENOUS THROMBOSIS Complications
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Incidental echocardiographic finding:Fractured inferior vena cava filter
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作者 Bhradeev Sivasambu Deepa Kabirdas Assad Movahed 《World Journal of Clinical Cases》 SCIE 2017年第4期148-152,共5页
Inferior vena cava filters have gained increasing popularity in recent decades and knowledge on rare complications becomes vital to practicing physicians. A 30-year-old African American male with diabetes mellitus, hy... Inferior vena cava filters have gained increasing popularity in recent decades and knowledge on rare complications becomes vital to practicing physicians. A 30-year-old African American male with diabetes mellitus, hypertension, end-stage renal disease, history of deep venous thrombosis and placement of venacaval filter who was seen in the cardiology clinic for cardiac risks stratification prior to renal transplant. Patient denied any cardiac symptoms. A transthoracic echocardiogram was performed and showed two linear echoes bright densities in the right atrium and right ventricle embedded which was later found to be fractured filter struts by computed tomography. We discuss the various outcomes associated with nonretrieval of retrievable inferior vena cava filters. 展开更多
关键词 INFERIOR vena cava filter Fractured INFERIOR vena cava filter CARDIAC FOREIGN body Metal in HEART INCIDENTAL echocardiographic finding
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A new type of inferior vena cava filter and its animal experiment
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作者 于学保 柳美荣 +1 位作者 郭锦芳 扈玉玲 《广东有色金属学报》 2005年第2期356-361,共6页
This article explains the definition of pulmonary embolism as well as its causes and elaborates on a new type of inferior vena cava filter(VCF)we have developed. Shaped like a waistdrum, the VCF is mainly made of TiNi... This article explains the definition of pulmonary embolism as well as its causes and elaborates on a new type of inferior vena cava filter(VCF)we have developed. Shaped like a waistdrum, the VCF is mainly made of TiNi shape memory alloy-wire. It has a subulate wire frame which can intercept the thrombus on each side. Its medial body is made up of straight shape memory alloy-wire . Every pillar is bound by several shape memory alloy springs. This type of inferior vena cava filter has a good resistance to fatigue and is hard to be broken. Through animal experiments its framework has been proved to be lasting. Neither deformation nor fragmentation happened when the VCF had been kept in the body for a long time. The thrombus interception efficiency of our VCF is higher than imported VCFs. The filter is unfavorable for thrombosis. After implantation, the IVC was completely unimpeded and no displacement occurred. Moreover the VCF did little damage to the Wall of vein. Neither IVC perforation nor haematoma occurred after the operation. 展开更多
关键词 静脉滤波器 形状记忆合金 肺部 栓子
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Clinical outcomes of Angio Jet pharmacomechanical thrombectomy versus catheter-directed thrombolysis for the treatment of filter-related caval thrombosis 被引量:2
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作者 Jin-Yong Li Jian-Long Liu +6 位作者 Xuan Tian Wei Jia Peng Jiang Zhi-Yuan Cheng Yun-Xin Zhang Xiao Liu Mi Zhou 《World Journal of Clinical Cases》 SCIE 2023年第3期598-609,共12页
BACKGROUND The inferior vena cava filter is utilized worldwide to intercept thrombi and to reduce the risk of fatal pulmonary embolism(PE).However,filter-related thrombosis is a complication of filter implantation.End... BACKGROUND The inferior vena cava filter is utilized worldwide to intercept thrombi and to reduce the risk of fatal pulmonary embolism(PE).However,filter-related thrombosis is a complication of filter implantation.Endovascular methods such as AngioJet rheolytic thrombectomy(ART)and catheter-directed thrombolysis(CDT)can treat filter-related caval thrombosis,but the clinical outcomes of both treatment modalities have not been determined.AIM To compare the treatment outcomes of AngioJet rheolytic thrombectomy vs catheter-directed thrombolysis in patients with filter-related caval thrombosis.METHODS In this single-center retrospective study,65 patients(34 males and 31 females;mean age:59.0±13.43 years)with intrafilter and inferior vena cava thrombosis were enrolled between January 2021 and August 2022.These patients were assigned to either the AngioJet group(n=44)or the CDT group(n=21).Clinical data and imaging information were collected.Evaluation measures included thrombus clearance rate,periprocedural complications,urokinase dosage,incidence of PE,limb circumference difference,length of stay,and filter removal rate.RESULTS Technical success rates were 100%in the AngioJet and CDT groups.In the AngioJet group,grade II and grade III thrombus clearance was achieved in 26(59.09%)and 14(31.82%)patients,respectively.In the CDT group,grade II and grade III thrombus clearance was accomplished in 11(52.38%)patients and 8(38.10%)patients,respectively(P>0.05).The peridiameter difference of the thigh was significantly reduced in patients from both groups after treatment(P<0.05).The median dosage of urokinase was 0.08(0.02,0.25)million U in the AngioJet group and 1.50(1.17,1.83)million U in the CDT group(P<0.05).Minor bleeding was shown in 4(19.05%)patients in the CDT group,and when it was compared with that in the AngioJet group,the difference was statistically significant(P<0.05).No major bleeding occurred.Seven(15.91%)patients in the AngioJet group had hemoglobinuria and 1(4.76%)patient in the CDT group had bacteremia.There were 8(18.18%)patients with PE in the AngioJet group and 4(19.05%)patients in the CDT group before the intervention(P>0.05).Computed tomography angiopulmonography(CTA)showed that PE was resolved after the intervention.New PE occurred in 4(9.09%)patients in the AngioJet group and in 2(9.52%)patients in the CDT group after theintervention(P>0.05).These cases of PE were asymptomatic.The mean length of stay was longer in the CDT group(11.67±5.34 d)than in the AngioJet group(10.64±3.52 d)(P<0.05).The filter was successfully retrieved in the first phase in 10(47.62%)patients in the CDT group and in 15(34.09%)patients in the AngioJet group(P>0.05).Cumulative removal was accomplished in 17(80.95%)out of 21 patients in the CDT group and in 42(95.45%)out of 44 patients in the ART group(P>0.05).The median indwelling time for patients with successful retrieval was 16(13139)d in the CDT group and 59(12231)d in the ART group(P>0.05).CONCLUSION Compared with catheter-directed thrombolysis,AngioJet rheolytic thrombectomy can achieve similar thrombus clearance effects,improve the filter retrieval rate,reduce the urokinase dosage and lower the risk of bleeding events in patients with filter-related caval thrombosis. 展开更多
关键词 Inferior vena cava filter THROMBOSIS AngioJet rheolytic thrombectomy Catheter-directed thrombolysis Clinical outcome
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Clinical study of domestic ZQL-type retrievable vena cava filter 被引量:1
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作者 XU Ke ZHOU Yu-bin +1 位作者 WANG Ai-lin XIAO Liang 《Chinese Medical Journal》 SCIE CAS CSCD 2009年第2期140-144,共5页
Background Pulmonary thromboembolism (PTE) is a serious disease often leading to disability and death. Percutaneous placement of an inferior vena cava (IVC) filter is an effective method to prevent fatal PTE cause... Background Pulmonary thromboembolism (PTE) is a serious disease often leading to disability and death. Percutaneous placement of an inferior vena cava (IVC) filter is an effective method to prevent fatal PTE caused by lower extremity deep venous thrombosis (LEDVT). We developed the ZQL-type retrievable vena cava filter. The aim of this study was to evaluate the safety and effectiveness of the ZQL-type filter for prevention of fatal PTE. Methods A total of 144 patients with indications for placement of an IVC filter received insertion of filters via a femoral (n=37) or jugular (n=107) vein approach. Abdominal X-ray and color Doppler ultrasonography of IVC were regularly performed to visualize the position and condition of the IVC filter following filter placement. If thrombi in the lower extremity deep veins were removed within 2 weeks, the filter retrieval procedure was performed after an abdominal radiograph, an inferior vena cavogram and a pulmonary angiography. Otherwise, the filter should be kept permanently in place with regular follow-up inspections. Results One hundred and forty-four filters were implanted at the target sites with a success rate of 98.61% for one-time placement and 100% for two-time placement. Of the 137 patients followed up (follow-up rate, 95.14%), 43 patients had filters retrieved during a period of between 7 and 14 days (median, 12 days) following filter placement. The remaining 94 patients were followed for 7 days to 39 months (median follow-up period, 17 months). No filter migration or tilt, filter fracture or IVC perforation was observed. No obstruction of IVC occurred. No symptomatic PTE developed during the follow-up period. Conclusion The ZQL-type retrievable vena cava filter is a safe and effective device to prevent PTE. This filter possesses a distinctive stent-shape, stable design, high capture efficacy, and is easy to insert and retrieve and thus is suitable for clinical application. Chin Med J 2009; 122(2): 140-144 展开更多
关键词 pulmonary embolism vena cava filters venous thrombosis
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Comparison of Biomechanical Properties and Hemodynamics of Three Different Vena Cava Filters
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作者 韩青松 蔡相文 +2 位作者 冯小娟 张庆祥 冯海全 《Journal of Shanghai Jiaotong university(Science)》 EI 2018年第6期803-810,共8页
The interaction mechanism of three types of vena cava filters(VCFs) with blood vessels and their influence on the bloodstream during the process of implantation are investigated by finite element method and computatio... The interaction mechanism of three types of vena cava filters(VCFs) with blood vessels and their influence on the bloodstream during the process of implantation are investigated by finite element method and computational fluid dynamics. The VCF models are set up with Solidworks software. Using ABAQUS software,we simulate the working conditions of the VCFs in the vessel to analyze the stress distribution and radial support stiffness of the vessel wall and the filter surface. Using FLUENT software, we simulate and analyze the velocity,pressure and shear stress distributions of blood flow when the VCFs are at their working conditions. For the retrievable VCF(R-VCF), the peak stress at the working conditions of the VCF is the highest, the peak stress toward the vessel wall is the lowest, and the support stiffness is the lowest. For the permanent VCF(P-VCF), the peak stress at the working conditions of the VCF is the highest, the peak stress toward the vessel wall is the lowest,and the support stiffness is the highest. Because of the structure of scaffolding support units and the tendency to form intimal hyperplasia on their support units, both the convertible VCF(C-VCF) and the P-VCF can embed their support units in the hyperplasia skin. This effectively prevents them from harming blood veins through filter damage at the pulse load conditions. As the biomechanical property of the C-VCF is between those of the R-VCF and the P-VCF, it has smaller obstacle to blood flow after conversion and has some fragmentation effects on the thrombus. The results show that different types of VCFs differ in their biomechanical and hemodynamic properties after implantation. Therefore, the simulative analysis can provide a reference basis for filter design and clinical decision making. 展开更多
关键词 vena cava filter (VCF) COMPUTATIONAL fluid dynamics FINITE ELEMENT method BIOMECHANICS PROPERTY
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High Inferior Vena Cava Thrombosis in a 16-year-old Postpartum Patient:A Case Report
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作者 魏勇 欧阳平 杨婉花 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2012年第1期149-150,共2页
Postpartum inferior vena cava (IVC) thrombosis is a rare,but potentially life-threatening disorder.Here we reported one case of the youngest woman to date who presented with massive IVC thrombus extending from deep ve... Postpartum inferior vena cava (IVC) thrombosis is a rare,but potentially life-threatening disorder.Here we reported one case of the youngest woman to date who presented with massive IVC thrombus extending from deep veins of the right leg to the level of the 11th thoracic vertebra,associated with asymptomatic pulmonary embolism. 展开更多
关键词 POSTPARTUM THROMBOSIS inferior vena cava filter pulmonary embolism
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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
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作者 胡杰 乔茂林 +12 位作者 田琴琴 王恒 闫盛 赵文博 史勇斌 师佩璐 邢淼 李海峰 金海将 王平 常文凯 王玉文 董红霖 《介入放射学杂志》 CSCD 北大核心 2024年第3期289-294,共6页
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... 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。 展开更多
关键词 腔静脉滤器 辐射剂量 装置取出
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下腔静脉滤器脱落移位至右髂外静脉1例
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作者 林宇佳 林龙潜 +2 位作者 廖政贤 张国栋 张文 《中国介入影像与治疗学》 北大核心 2024年第7期448-448,共1页
患者男,87岁,左下肢肿胀、疼痛1月余,加重并红肿4天;患慢性阻塞性肺疾病多年,具体不详。查体:左大腿内侧至小腿上段肿胀,皮肤潮红、皮温升高,波动感(+)。下肢静脉超声见左侧腘静脉至胫后静脉局部血栓形成。于左小腿抽出暗红色脓液,细菌... 患者男,87岁,左下肢肿胀、疼痛1月余,加重并红肿4天;患慢性阻塞性肺疾病多年,具体不详。查体:左大腿内侧至小腿上段肿胀,皮肤潮红、皮温升高,波动感(+)。下肢静脉超声见左侧腘静脉至胫后静脉局部血栓形成。于左小腿抽出暗红色脓液,细菌涂片显示革兰氏阳性球菌(++)。 展开更多
关键词 腔静脉滤器 异物游走 腔静脉 髂静脉
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不同入路放置下腔静脉滤器的效果分析
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作者 孙磊 亓雪 任永才 《医学影像学杂志》 2024年第4期86-88,92,共4页
目的 探讨经颈静脉和经股静脉不同入路置入下腔静脉滤器(Inferior vena cava filter,IVCF)的效果差异。方法 选取我院收治的股静脉穿刺置管后发生急性髂股静脉血栓形成且单纯行IVCF置入术后资料完整患者66例,按IVCF置入的不同入路将以... 目的 探讨经颈静脉和经股静脉不同入路置入下腔静脉滤器(Inferior vena cava filter,IVCF)的效果差异。方法 选取我院收治的股静脉穿刺置管后发生急性髂股静脉血栓形成且单纯行IVCF置入术后资料完整患者66例,按IVCF置入的不同入路将以上患者分为经颈静脉入路组和经股静脉入路组,比较两组在出血、IVCF倾斜、排尿困难、腰背疼痛、舒适度、满意度、睡眠质量等方面的效果差异。结果 经颈静脉入路组排尿困难发生率低于经股静脉入路组,差异有统计学意义(P<0.05)。经颈静脉入路组腰背疼痛评分和睡眠质量平均评分均低于经股静脉入路组,差异有统计学意义(P<0.05),舒适度、满意度评分均高于经股静脉入路组,差异有统计学意义(P<0.05)。结论 经颈静脉穿刺IVCF置入可以降低患者术后排尿困难以及腰背疼痛的情况发生,患者具有较高的舒适度、满意度以及睡眠质量。 展开更多
关键词 下腔静脉滤器 下肢深静脉血栓形成 颈静脉入路 股静脉入路 介入性 放射学
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股静脉途径夹角预测锥形下腔静脉滤器倾斜研究
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作者 宋均飞 龙海灯 殷世武 《齐齐哈尔医学院学报》 2024年第6期551-554,共4页
目的了解髂总静脉与下腔静脉夹角、髂总静脉与髂外静脉夹角与锥形下腔静脉滤器(IVCF)置入时倾斜之间的关系,为临床IVCF置入手术入路选择、IVCF类型选择提供参考。方法回顾性分析2019年1月—2021年9月本院介入科收治的86例行锥形IVCF置... 目的了解髂总静脉与下腔静脉夹角、髂总静脉与髂外静脉夹角与锥形下腔静脉滤器(IVCF)置入时倾斜之间的关系,为临床IVCF置入手术入路选择、IVCF类型选择提供参考。方法回顾性分析2019年1月—2021年9月本院介入科收治的86例行锥形IVCF置入术患者的临床资料,根据术中DSA影像资料,采用ROC分析髂总静脉与下腔静脉之间夹角、髂总静脉与髂外静脉之间夹角以及两者结合对IVCF置入后倾斜的预测价值。结果右股静脉入路,髂总静脉与下腔静脉夹角预测IVCF置入后不倾斜(滤器倾斜角度小于5°)的AUC(0.630)大于髂总静脉与髂外静脉夹角(0.554)、两者结合(0.609)。髂总静脉与下腔静脉角度最佳截断值156.5°;左股静脉入路,髂总静脉与下腔静脉夹角预测IVCF置入后不倾斜AUC(0.908)大于髂总静脉与髂外静脉夹角(0.689)、两者结合(0.852)。髂总静脉与下腔静脉夹角最佳截断值135°。结论IVCF置入时,经左股静脉入路,造影后髂总静脉与下腔静脉角度小于135°或经右股静脉入路,造影后髂总静脉与下腔静脉角度小于156.5°,锥形滤器发生倾斜可能性大,建议选择其他入路或者选择其他类型IVCF。 展开更多
关键词 下肢深静脉血栓 下腔静脉滤器 并发症 倾斜
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可回收下腔静脉滤器留置的高危临床特征
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作者 查振平 潘力生 +4 位作者 方灿军 丁振 聂宗杰 柏霞 鲍士秀 《血管与腔内血管外科杂志》 2024年第5期578-582,587,共6页
目的了解下腔静脉滤器放置及回收情况,分析可回收滤器释放的适应证分布,研究滤器留置的高危临床特征。方法收集2021年9月至2022年9月于安庆市立医院接受下腔静脉滤器置入的116例患者的临床资料。分析所有患者的滤器置入、适应证分布、... 目的了解下腔静脉滤器放置及回收情况,分析可回收滤器释放的适应证分布,研究滤器留置的高危临床特征。方法收集2021年9月至2022年9月于安庆市立医院接受下腔静脉滤器置入的116例患者的临床资料。分析所有患者的滤器置入、适应证分布、并发症发生情况。通过随访确定滤器回收情况,统计主观回收成功率和技术回收成功率,明确患者对滤器取出的认知状态和患者的生存情况。根据滤器取出情况将患者分为滤器取出组(n=62)与滤器留置组(n=54),比较两组患者的临床特征,并分析下腔静脉滤器留置的危险因素。结果116例患者中,滤器置入的相对适应证患者96例(82.8%),绝对适应证患者20例(17.2%),无预防性置入病例。下腔静脉滤器的主观尝试回收成功率为53.4%(62/116),技术回收成功率为100%。两组患者的年龄、肿瘤合并情况、是否血管外科出院、存在抗凝禁忌情况及诊断条目比较,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≥65岁、诊断条目≥7条、非血管外科出院均是下腔静脉滤器留置的独立危险因素(P﹤0.05)。结论患者对滤器的选择和术后专科化的随访管理对滤器的取出率均有影响,临床中应根据高危因素决定是否放置滤器及选择合适的滤器,并且加强术后随访管理,提高下腔静脉滤器取出率。 展开更多
关键词 下腔静脉滤器 可回收滤器 适应证 滤器留置 危险因素
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腔静脉滤器的应用进展
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作者 胡春梅 田鑫悦 陈蒙华 《血管与腔内血管外科杂志》 2024年第2期180-184,209,共6页
深静脉血栓(DVT)是临床常见的疾病,急性期发生血栓脱落可引起肺栓塞(PE),其病死率极高。应用腔静脉滤器拦截DVT脱落的栓子流向右心房可有效降低PE的发生率及其危害程度。腔静脉滤器可根据放置位置的不同分为下腔静脉滤器和上腔静脉滤器... 深静脉血栓(DVT)是临床常见的疾病,急性期发生血栓脱落可引起肺栓塞(PE),其病死率极高。应用腔静脉滤器拦截DVT脱落的栓子流向右心房可有效降低PE的发生率及其危害程度。腔静脉滤器可根据放置位置的不同分为下腔静脉滤器和上腔静脉滤器。下腔静脉滤器又可因使用时间的不同分为永久性滤器和非永久性滤器,后者可进一步细分为临时性、可回收性、可转换型滤器等。本文就近年来国内外关于预防PE的滤器种类和治疗效果进行简要综述,旨在为临床医师合理选用腔静脉滤器提供参考。 展开更多
关键词 深静脉血栓 肺栓塞 静脉血栓栓塞症 腔静脉滤器 应用进展
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TempofilterⅡ滤器在肾癌伴静脉癌栓手术治疗中的应用(附18例报告) 被引量:1
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作者 于宏志 房杰 +4 位作者 高翔 张喆 刘彬 李晨宇 陈学明 《中国血管外科杂志(电子版)》 2016年第4期286-290,共5页
目的总结肾癌合并静脉癌栓行根治手术前,预先植入TempofilterⅡ临时滤器预防肺栓塞的效果。方法回顾性分析2013年1月至2016年5月18例确诊为肾癌合并静脉癌栓的患者资料,预先植入TempofilterⅡ临时滤器,后行肾癌切除和静脉癌栓取栓术,并... 目的总结肾癌合并静脉癌栓行根治手术前,预先植入TempofilterⅡ临时滤器预防肺栓塞的效果。方法回顾性分析2013年1月至2016年5月18例确诊为肾癌合并静脉癌栓的患者资料,预先植入TempofilterⅡ临时滤器,后行肾癌切除和静脉癌栓取栓术,并于术中或术后取出滤器。肾静脉及下腔静脉癌栓分级:0级4例,Ⅰ级2例,Ⅱ级10例,Ⅲ级2例。结果全部患者先行植入下腔静脉TempofilterⅡ临时滤器,技术成功率100%,无相关围术期并发症发生。术后取出临时滤器时间间隔为0~9天[平均为(4.1±2.5)天]。取出的滤器均形态完整,无滤丝折断、滤器移位发生。1例患者于滤器取出术后3个月发现颈部皮肤转移癌。结论对于肾癌合并静脉癌栓患者,预先植入TempofilterⅡ临时滤器预防肺栓塞是安全、可行的。滤器取出过程需要加以改进,以减少医源性肿瘤脱落种植风险。 展开更多
关键词 下腔静脉 肾癌 癌栓 静脉滤器 医源性肿瘤种植
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腔静脉滤器困难性回收Nomogram个体化预测模型
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作者 于姗姗 谢佳怡 +1 位作者 薛碧晨 徐宏博 《Journal of Central South University》 SCIE EI CAS CSCD 2024年第5期1637-1645,共9页
腔静脉滤器是为预防深静脉血栓脱落导致致命性肺栓塞而设计的装置,在滤器回收过程中常出现不同程度的技术困难,需借助辅助器械和静脉通路。建立有效的预测模型提前预测滤器回收困难程度有助于术前规划、沟通和术中高效配合。本文回顾性... 腔静脉滤器是为预防深静脉血栓脱落导致致命性肺栓塞而设计的装置,在滤器回收过程中常出现不同程度的技术困难,需借助辅助器械和静脉通路。建立有效的预测模型提前预测滤器回收困难程度有助于术前规划、沟通和术中高效配合。本文回顾性分析2011年1月至2020年12月在中南大学湘雅三医院进行的477例腔静脉滤器回收病例,其中顺利回收344例,困难性回收137例(包括35例回收失败)。运用单因素与多因素logistic回归分析筛选困难性回收的相关风险因素,再构建Nomogram预测模型并用ROC曲线验证模型的准确性,其中2011年1月至2017年12月病例资料为训练队列,2018年1月至2020年12月资料为验证队列。单因素分析结果显示滤器是否贴壁、滤器是否穿透腔静脉、滤器与血管长轴之间夹角、实际使用时间与建议置入时间比值、是否规律抗凝是腔静脉滤器困难性回收的风险因素,在此基础上进一步使用logistic多因素回归分析显示,滤器是否贴壁、滤器是否穿透腔静脉、是否规律抗凝是预测腔静脉滤器困难性回收的独立风险因素。将上述三种风险进一步构建Nomogram预测模型,内部验证评价AUC值为0.819,外部验证评价AUC值为0.817;内部验证和外部验证的校准曲线均提示模型能有效预测困难性回收风险。构建腔静脉滤器困难性回收Nomogram图预测模型的纳入变量在术前易于获得,模型具有较好的预测效果和较低的泛化误差,可为血管介入医生在腔静脉滤器回收治疗决策提供重要依据。 展开更多
关键词 诺模图 下腔静脉滤器回收 单变量和多变量逻辑回归分析 校准曲线分析 医院信息系统
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