一种自制可取出式腔静脉滤过器的实验研究  

The experimental study of a self-made retrievable vena caval filter

作　　者：姜宏[1] 徐克[1] 冯博[1] 黄亘[1] 张斌[1] 范世刚 刘小倩[1] 

机构地区：[1]中国医科大学附属第一医院放射科,沈阳110001 [2]解放军第四六三医院放射科

出　　处：《中华放射学杂志》2000年第8期559-562,共4页Chinese Journal of Radiology

基　　金：国家"九五"攻关项目子课题!( 96 90 7 0 1 0 2 )

摘　　要：目的　评价自制可取出式不锈钢 (316L改进型 )腔静脉滤过器 (self maderetrievablevenacavalfilter,SRVCF)的安全性及有效性。方法　 (1)通过体外实验装置检验SRVCF的滤过率及捕获栓子后的两端静脉压差。 (2 ) 8条犬按SRVCF置入后观察时间 (10d、2周、3周和 4周 )随机分为 4组 ,每组 2条 ;经股静脉将SRVCF置入下腔静脉 ;按预定时间 ,将每组中 1条犬当即处死取材 ,另 1条犬经颈静脉将SRVCF取出观察 2周后处死取材 ;除血管造影外 ,还进行光、电镜检查。结果　 (1) 5mm×30mm栓子的滤过率水平位及垂直位均为 10 0 %。捕获 4块 7mm× 2 0mm栓子后 ,两端压力差为9 5cmH2 O (1cmH2 O =0 .98Pa)。 (2 )SRVCF置入均成功。 10d组和 2周组取出顺利 ,内膜轻度损伤 ,2周后修复完好。 3周组和 4周组未能取出。造影显示腔静脉畅通 ,SRVCF无倾斜和移位。大体观察未见腹膜后出血、腔静脉穿孔及血栓形成。光、电镜下 ,2周时SRVCF固定部被一薄层未成熟的新生内膜覆盖 ;4周时内膜成熟并增厚 ;钢丝和焊点未见腐蚀。结论　SRVCF具有 :(1)较高的滤过率 ,同时对血流影响不大 ;(2 )定位稳定而不倾斜 ;(3)具有较好的生物相容性、低致血凝性和耐腐蚀性 ;(4) 2周内可顺利取出。Objective To evaluate the safety and efficiency of a self made retrievable vena caval filter(SRVCF) constructed of round stainless steel wire (improved 316L). Methods (1)The clot trapping capacity and flow dynamics of SRVCFs were evaluated in a flow model. (2)8 mongrel dogs were divided to 4 groups at random according to the time (10 days, 2 weeks, 3 weeks, 4 weeks) after the SRVCFs were deployed, with 2 dogs in each group. The SRVCFs were deployed in inferior vena cava (IVC) by femoral vein. One of each group was killed and sampled on time, so was the other at 2 weeks after the SRVCF was retrieved by jugular. Angiography, microscope and electron microscope examination were performed. Results (1)The filtering efficiency for 5 mm×30 mm thrombi was 100% in horizontal or vertical position. The trans SRVCF pressure gradient was 9.5 cm H 2O after 4 clots of 7 mm×20 mm thrombus were captured.(2) All SRVCFs were deployed successfully. The retrieval of SRVCFs was easy at 10 days group and 2 weeks group, but failed at 3 weeks group and 4 weeks group. Angiography displayed that the cavity of IVC was patent. The SRVCFs did not occur tilting and migration. Postmortem displayed that there were not retroperitoneal hemorrhage and caval penetration or thrombosis. Although retrieval resulted in slight intimal injury, the injury had restored 2 weeks later. Under microscope, a thin layer of neointima covered the anchoring struts of SRVCFs at 2 weeks and became thick at 4 weeks. Under scan electron microscope, endothelial cells were premature at 2 weeks and mature at 4 week. The soldering joint and wire of SRVCFs were not eroded. Conclusion The filtering efficiency of SRVCFs was high with little influence on hydrodynamics. SRVCF has satisfied biological compatibility, nonthrombogenesis, and antierrosivity. It anchored well and untilted. Its retrieval was easy in 2 weeks.

关 键 词：可取出式腔静脉滤过器 肺栓塞 预防 实验研究 

分 类 号：R197.39[医药卫生—卫生事业管理]