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下腔静脉滤器置入术预防致死性肺动脉栓塞:附三例分析 总被引:29,自引:1,他引:28
下腔静脉滤器置入术预防下肢深静脉血栓形成后血栓脱落,发生致死性肺动脉栓塞,在欧美等国已得到广泛应用。作者总结了3例下肢深静脉血栓形成后抗凝和/或溶栓治疗无效的病例。男2例,女1例。采用钛质Greenfield下腔静脉滤器,以12F直径的输送鞘管置入,滤器置下肾静脉下方的下腔静脉内。2例左髂股静脉血栓形成,经右股静脉置入,1例右侧病变,经左侧进路。随诊1 ̄12个月,观察到1例滤器向头端移位0.7cm 相似文献
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下肢深静脉血栓 (deepveinthrombus ,DVT)在临床上并非少见 ,其主要危害是血栓脱落 ,造成致死性肺动脉栓塞 ( pul monaryembolus ,PE) [1,2 ] 。经皮下腔静脉滤器的置入 ,能有效防止下肢深静脉脱落的血栓进入肺动脉内 ,预防猝死性PE的发生[3 ] 。本院自 2 0 0 1年 7月以来 ,对临床确诊的 6例DVT患者置放了下腔静脉滤器 ,均取得预期的临床效果。材料与方法1.一般资料本组 6例患者 ,男 4例 ,女 2例 ,年龄 46~ 73岁 ,平均 5 6.3岁。 5例为左下肢深静脉血栓形成 ,1例为右下肢深静脉血栓形成。其中 5… 相似文献
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肺动脉栓塞是肢体深静脉血栓(Deep vein thrombosis,DVT)形成后的严重合并症.竹中秀裕[1]统计935例肺动脉栓塞,因DVT所致为72%.国内研究表明[2],在DVT患者中,45%可以发生肺动脉栓塞.近年来随着上述观点逐渐被人们接受,作为预防肺动脉栓塞发生的重要手段-腔静脉滤器(以下为滤器),已被广泛应用于临床,1998~2007年底我院为140例患者植入滤器,现将临床护理报告如下. 相似文献
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LGM腔静脉滤器预防恶性肿瘤病人肺动脉栓塞 总被引:1,自引:0,他引:1
目的 :探讨 L GM腔静脉滤器运用于恶性肿瘤病人预防肺动脉栓塞的效果、并发症。方法 :对 2 1例患有恶性肿瘤因血栓栓塞性疾病而安放 L GM腔静脉滤器的病人进行回顾性研究 ,分析早期、长期并发症 ,了解有无再发肺动脉栓塞。结果 :2 1只滤器都成功安放 ,1只倾斜 >15°(4 .8% ) ;追踪期内有 1只滤器向尾侧移位 >1个椎体 ,1例再发肺动脉栓塞 (4 .8% ) ,该只滤器部位有血栓形成。结论 :使用 L GM腔静脉滤器并发症少 ,对合并恶性肿瘤的血栓栓塞性疾病病人再发肺动脉栓塞有良好的预防作用 相似文献
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腔静脉滤器预防肺动脉栓塞的长期追踪 总被引:4,自引:0,他引:4
目的评价腔静脉滤器对肺动脉栓塞的预防效果、使用中的问题和并发症.方法对61例置放腔静脉滤器的病人进行追踪随访,其中静脉Tech-LGM滤器(vena Tech-LGM filter, VTF)55只,Titanium-Greenfield 滤器(TGF)6只,随访期3~72个月,平均27个月,了解有无再发肺动脉栓塞,复查腹部平片,做滤器处彩超和CT检查.结果 61只滤器中,置放时有1只不全张开,1只倾斜角>15°.复查时,1只滤器远心向移位>1个椎体,9只滤器内发现有血栓性物质.1例在置放滤器后再发肺动脉栓塞(1.6%).结论腔静脉滤器预防肺动脉栓塞简便、安全、有效,但是使用应严格掌握适应证. 相似文献
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目的探讨经皮穿刺下腔静脉滤器植入术(IVCF)预防肺动脉栓塞症的临床应用价值。方法自2004年9月—2007年1月对10例下肢深静脉血栓形成患者施行IVCF植入术。男6例,女4例,年龄45~79岁,患者经健侧股静脉径路植入IVCF全部成功,植入部位均为肾静脉开口水平以下,随访12~30个月。结果本组10例均成功植入,术后无局部血肿及血栓形成,均无肺栓塞发生,无一例滤器移位、腔静脉血栓阻塞和死亡。然而5例患者均残存不同程度的患侧肢体麻木、无力、肿胀等下肢静脉功能不全症状。1例术后1月停用华法林,自行中药治疗而再次股静脉栓塞,但未发生肺栓塞。结论IVCF植入术能有效预防肺动脉栓塞,并防止再发肺栓塞所致死亡,对深静脉血栓形成患者是一种安全、有效的防治措施。 相似文献
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腔静脉滤器在深静脉血栓治疗中的应用价值及置入体会 总被引:3,自引:3,他引:3
目的探讨腔静脉滤器(VCF)在深静脉血栓治疗中的作用及置入体会。方法43例下肢深静脉血栓形成患者,经股静脉放置43枚SimonNitinol型VCF(SimonNitinolFilter,SNF),42枚位置均在肾静脉开口下方,1枚位置在肾静脉开口上方,并结合积极的抗凝溶栓治疗。结果43枚滤器均放置成功,出现穿刺部位较大血肿2例、滤器血栓形成1例,患者症状、体征明显改善。随访1~60个月,均未发生肺栓塞。结论在深静脉血栓治疗中,放置SNF可以有效地预防肺栓塞,只要掌握其操作方法及技巧,均能成功地放置滤器、减少并发症。 相似文献
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下腔静脉滤器预防肺栓塞的临床应用 总被引:31,自引:0,他引:31
目的:评价置入下腔静脉滤器预防因下肢静脉血栓脱落引起肺栓塞的效果和安全性。材料与方法:16例下肢深静脉血栓患者置入钛质Grenfieldfilter(TKG)12例,Bird’snestfilter(BNF)4例。滤器位于双肾静脉水平以下的腔静脉内。术后分别于1、6、12个月摄腹部平片复查,观察滤器的位置、形态变化。结果:全部滤器经股静脉穿刺置入,经右股静脉13例,左股静脉3例,无严重并发症发生。随访发现TKG2例向足侧移位,1例向头侧移位,1例跨度增大,腹部CT,腔静脉造影发现滤器的1只脚穿透腔静脉壁,未出现任何症状;2例发生滤器偏斜,角度小于15°。BNF未见位置改变。无1例发生腔静脉阻塞或复发肺栓塞。结论:置入下腔静脉滤器预防肺栓塞是安全、有效的方法。 相似文献
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目的探讨hegisy可回收腔静脉滤器预防肺动脉栓塞的临床应用价值。方法对32例急性或亚急性下肢深静脉血栓形成(deep vein thrombosis,DVT)和(或)肺动脉栓塞(pulmonary embolism,PrO的患者经健侧股静脉置入滤器,经用药物或手术治疗,观察有无肺动脉栓塞症状及有无肺动脉栓塞症状加重情况,滤器有无形态及位置变化。结果下腔静脉滤器置入全部成功,下肢深静脉血栓形成患者治疗后效果良好,无症状性肺动脉栓塞发生,置入滤器平均(14.0±2.0)天,取出可回收滤器捕捉血栓24例,占75%。结论可回收下腔静脉滤器预防肺动脉栓塞的疗效确切,具有较高的临床应用价值。 相似文献
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Eric J. Hohenwalter James R. Stone Paul V. O’Moore Steven J. Smith J. Bayne Selby Robert J. Lewandowski Shaun Samuels Paul M. Kiproff David W. Trost David C. Madoff Jeremy Handel Eric J. Gandras Athanasios Vlahos William S. Rilling 《Journal of vascular and interventional radiology : JVIR》2017,28(10):1353-1362
Purpose
To demonstrate rates of successful filter conversion and 6-month major device-related adverse events in subjects with converted caval filters.Materials and Methods
An investigational device exemption multicenter, prospective, single-arm study was performed at 11 sites enrolling 149 patients. The VenaTech Convertible Vena Cava Filter (B. Braun Interventional Systems, Inc, Bethlehem, Pennsylvania) was implanted in 149 patients with venous thromboembolism and contraindication to or failure of anticoagulation (n = 119), with high-risk trauma (n = 14), and for surgical prophylaxis (n = 16). When the patient was no longer at risk for pulmonary embolism as determined by clinical assessment, an attempt at filter conversion was made. Follow-up of converted patients (n = 93) was conducted at 30 days, 3 months, and 6 months after conversion. Patients who did not undergo a conversion attempt (n = 53) had follow-up at 6 months after implant.Results
All implants were successful. One 7-day migration to the right atrium required surgical removal. Technical success rate for filter conversion was 92.7% (89/96). Mean time from placement to conversion was 130.7 days (range, 15–391 d). No major conversion-related events were reported. The mean conversion procedure time was 30.7 minutes (range, 7–135 min). There were 89 converted and 32 unconverted patients who completed 6-month follow-up with no delayed complications.Conclusions
The VenaTech Convertible filter has a high conversion rate and low 6-month device-related adverse event rate. Further studies are necessary to determine long-term safety and efficacy in both converted and unconverted patients. 相似文献14.
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中华医学会放射学分会介入学组 《介入放射学杂志》2011,20(5):340-344
在回顾历史、分析现状的基础上,提出下腔静脉滤器置入术和取出术的适应证与禁忌证.对围手术期处理、操作步骤、并发症防治作了归纳总结和说明.强调尽量使用临时性滤器和可取出滤器,以降低由于滤器长期置入而引起的并发症的发生率. 相似文献
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《Techniques in Vascular and Interventional Radiology》2017,20(3):197-205
Pulmonary embolism (PE) is a cause of significant morbidity and mortality, with an estimated 600,000 cases of clinically significant PE in the United States annually, and roughly 200,000 deaths per annum directly attributable to PE. By far the most frequent cause of PE is deep vein thrombosis originating in the lower extremities, which travels to the pulmonary vasculature. The mainstay of treatment is anticoagulation, but multiple additional treatments exist for patients in whom anticoagulation is inadequate or contraindicated. The absolute indications for inferior vena cava (IVC) filtration are narrow, but many filters are placed in patients with relative indications. There is growing concern for overuse of IVC filters, with a relatively low rate of retrieval. It is essential for interventional radiologists to understand the appropriate and correct use and retrieval of IVC filters. Familiarity with placement techniques, protocols and techniques for retrieval, current and emerging technologies, and the clinical model for management of venous thromboembolism, will ensure that interventional radiologists remain an integral member of the care team for these often complex patients. 相似文献