Long-term results of the Simon nitinol inferior vena cava filter
Long-term results of the Simon nitinol inferior vena cava filter
复制标题
西蒙镍钛合金下腔静脉过滤器的长期结果
DOI：
10.1007/s003300050382
复制
发表时间：
1998
影响因子：
5.9
通讯作者：
François Terrier
中科院分区：
文献类型：
--
作者：
Pierre;Christoph D. Becker;L. Prina;P. Ruijs;Henri Bounameaux;Dominique Didier;P. Schneider;François Terrier
本研究的目的是评估西蒙镍钛诺下腔静脉滤器（SNF）的临床疗效、机械稳定性和安全性。 SNF 被植入两个机构的 114 名连续患者中，用于预防肺栓塞 (PE)。回顾性获得所有患者的临床随访数据，其中 38 名患者接受了专门的放射学随访方案，包括腹部 X 光检查、多普勒超声检查和 CT。插入过滤器后没有立即出现并发症。插入过滤器后，平均 50 名患者死亡 5.6 (1-23) 个月，平均 64 名患者在插入过滤器后 27 (3-62) 个月存活。 5 名患者 (4.4%) 记录有复发性肺栓塞，但 1 名患者起源于过滤器远端。深静脉血栓 (DVT) 的发生率为 5.3%，穿刺部位血栓的发生率为 3.5%，下腔静脉血栓的发生率为 3.5%。接受长期抗凝治疗的患者和未接受长期抗凝治疗的患者的血栓栓塞并发症发生率相似。放射学随访显示平均 32 (5-62) 个月后过滤器未发生迁移。 CT检查显示，SNF的支柱95%已穿透腔静脉，76%与邻近器官接触；然而，没有出现由过滤器引起的临床症状。 63% 的人发现过滤器处于偏心位置，16% 的人发现过滤器部分损坏；但这并不影响过滤功能。插入 SNF 后肺栓塞复发率为每名患者每年 2.4%。无论长期抗凝治疗如何，腔静脉血栓形成率都较低，可以接受。除了偶尔的进入部位血栓形成外，没有观察到其他与过滤器相关的发病率。
The aim of this study was to evaluate the clinical efficacy, mechanical stability, and safety of the Simon nitinol inferior vena cava filter (SNF). The SNF was inserted in 114 consecutive patients at two institutions for prophylaxis of pulmonary embolism (PE). Clinical follow-up data were obtained retrospectively on all patients, and 38 patients underwent a dedicated radiologic follow-up protocol consisting of abdominal radiography, Doppler sonography, and CT. There was no immediate complication following filter insertion. Fifty patients died, on average, 5.6 (1–23) months after filter insertion, and 64 patients were alive, on average, 27 (3–62) months after filter insertion. Recurrent pulmonary embolism was documented in 5 patients (4.4 %) but originated distal to the filter in 1 patient. Deep venous thrombosis (DVT) was documented in 5.3 %, thrombosis at the access site in 3.5 %, and thrombosis of the inferior vena cava in 3.5 %. The rate of thromboembolic complications was similar in patients who did receive long-term anticoagulation and in those who did not. Radiologic follow-up showed no filter migration after, on average, 32 (5–62) months. A CT examination showed that struts of the SNF had penetrated the vena cava in 95 %, and were in contact with adjacent organs in 76 %; however, there were no clinical symptoms attributable to the filter. Filters were in an eccentric position in 63 % and partial filter disruption was found in 16 %; however, this did not affect filter function. The rate of recurrent pulmonary embolism after insertion of the SNF is 2.4 % per patient per year. Regardless of long-term anticoagulation, the rate of caval thrombosis is acceptably low. Except for occasional access-site thrombosis, no other filter-related morbidity was observed.