下腔静脉滤器回收安全性和滤器附着物组织学分析  

Safety of inferior vena cava filter retrieval and histological analysis of filter attachment substances

作　　者：王书青 胡家钱 廉维帅 吴永发 谢晓云 李茂全[1] WANG Shuqing;HU Jiaqian;LIAN Weishuai;WU Yongfa;XIE Xiaoyun;LI Maoquan(Department of Interventional and Vascular Surgery,Affiliated Tenth People′s Hospital,Tongji University,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院介入血管外科,上海200072 [2]蚌埠市第二人民医院介入科

出　　处：《介入放射学杂志》2024年第10期1073-1077,共5页Journal of Interventional Radiology

摘　　要：目的分析可回收性下腔静脉滤器的回收率和安全性,以及滤器附着物的组织学分析。方法回顾性收集2020年6月至2023年5月上海市第十人民医院收治的234例行取除下腔静脉滤器患者的临床资料,统计回收成功率、并发症及滤器附着物等情况,采用组织染色分析附着物性质。结果234例行取除下腔静脉滤器患者中成功回收率91.03%(213/234),17例因滤器捕获血栓放弃回收,4例因滤器倾斜回收失败。所有患者围术期未发生腔静脉穿孔、症状性肺动脉栓塞及出血等并发症。成功回收213例滤器中含有附着物156例,附着物组织学染色显示主要成分为混合血栓伴有少量纤维素退变。进一步分析表明,滤器附着物在≤14 d组发生率低于>14 d组,两组比较差异具有统计学意义(χ^(2)=6.791,P=0.009);非抗凝组滤器附着物发生率低于抗凝组,两组比较差异具有统计学意义(χ^(2)=7.774,P=0.005)。结论可回收性下腔静脉滤器取出率高,相关并发症少,在临床中应用安全性高,但滤器置入后滤器微小血栓形成不容忽视,在临床工作中应引起重视。Objective To analyze the retrieval rate of inferior vena cava filter(IVCF)and its safety,and to make a histological analysis of the filter attachment substances.Methods The clinical data of 234 patients with IVCF,who were admitted to Affiliated Tenth People′s Hospital,Tongji University,to retrieve IVCF between June 2020 and May 2023,were retrospectively analyzed.The retrieval success rate,complications and filter attachment substances were statistically analyzed,and the nature of the attachment substances was examined by using histological staining.Results The retrieval success rate in the 234 patients was 91.03%(213/234).In 17 patients the retrieval of IVCF was abandoned due to the filter capturing the thrombus,and in 4 patients the retrieval of IVCF failed due to tilting of the filter.No complications such as vena cava perforation,symptomatic pulmonary embolism and hemorrhage occurred in all patients during perioperative period.Of the 213 patients whose filter was successfully removed,the filter attachment substances was found in 156 patients.Histological staining of the filter attachment substances demonstrated that the main component of these substances was a mixed thrombus with a small amount of cellulose degeneration.Further analysis revealed that the incidence of filter attachment substances in≤14-day group was lower than than that in>14-day group,and the difference between the two groups was statistically significant(χ^(2)=6.791,P=0.009);and the incidence of filter attachment substances in the non-anticoagulant group was lower than that in the anticoagulant group,and the difference between the two groups was statistically significant(χ^(2)=7.774,P=0.005).Conclusion The retrieval rate of retrievable IVCFs is quite high and the retrieval procedure carries less complications,therefore,it is safe to use retrievable IVCFs in clinical practice.However,the formation of tiny thrombosis within the filter after the placement of filter cannot be ignored,which should be seriously considered in the clinical work

关 键 词：腔静脉滤器 深静脉血栓 滤器回收 安全性 混合血栓 

分 类 号：R608[医药卫生—外科学]