Percutaneous Retrieval of Permanent Inferior Vena Cava Filters
Percutaneous Retrieval of Permanent Inferior Vena Cava Filters
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DOI：
10.1007/s00270-015-1214-0
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发表时间：
2016-04-01
影响因子：
2.9
通讯作者：
Lessne, Mark L.
中科院分区：
文献类型：
--
作者：
Tamrazi, Anobel;Wadhwa, Vibhor;Lessne, Mark L.
评价经皮取出永久性TrapEase和Simon镍钛合金下腔静脉滤器的可行性、风险和技术。（5名妇女，7名男子;年龄范围，26-75岁）尝试经皮取出永久性TrapEase（10）和Simon镍钛合金（2）由于IVC滤器并发症病史或因滤器需要终身抗凝治疗而使用IVC滤器。回顾了滤器留置时间、髂腔静脉深静脉血栓形成、手术技术和并发症的医疗记录，滤器留置时间从7天到15年不等（平均5.1年）。12例患者中有11例（91.6%）成功取出永久性IVC滤器。在1例患者中，尽管有激光鞘管辅助，但仍无法取出慢性血栓形成的IVC滤器，但使用PowerWire RF导丝成功实现了再通。在失败的回收尝试中，通过慢性血栓形成的IVC滤器放置了一枚支架，恢复了管路内血流。一个主要的并发症是腹股沟大静脉血肿，在精心挑选的患者中，尽管滤器留置时间延长，但经皮永久性下腔静脉滤器的移除仍然可以安全进行。经颈静脉和股静脉入路可促进长期嵌入的永久性下腔静脉滤器的取出，通常需要激光鞘管辅助。慢性滤器血栓形成和腔静脉瘢痕可能增加回收失败的风险。
To evaluate the feasibility, risks, and techniques of percutaneous removal of permanent TrapEase and Simon Nitinol IVC filters.Between August 2011 and August 2015, 12 patients (5 women, 7 men; age range, 26-75 years) underwent an attempt at percutaneous removal of permanent TrapEase (10) and Simon Nitinol (2) IVC filters due to a history of IVC filter complications or need for lifelong anticoagulation due to the filter. Medical records were reviewed for filter dwell time, presence of iliocaval deep venous thrombosis, procedural technique, and complications.Filter dwell times ranged from 7 days to 15 years (mean 5.1 years). Successful removal of permanent IVC filters was possible in 11 of 12 patients (91.6 %). In 1 patient, a chronically thrombosed IVC filter could not be removed despite laser sheath assistance, but was successfully recanalized with the PowerWire RF guidewire. In the failed retrieval attempt, a stent was placed through the chronically thrombosed IVC filter with restoration of in-line flow. One major complication of large venous groin hematoma was encountered.In carefully selected patients, percutaneous removal of permanent IVC filters can be performed safely despite prolonged filter dwell times. Extraction of chronically embedded permanent IVC filters may be facilitated by jugular and femoral approaches, often with laser sheath assistance. Chronic filter thrombosis and caval scarring may increase the risk of retrieval failure.