共查询到20条相似文献,搜索用时 15 毫秒
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Le Blanche AF Ricco JB Bonneau M Reynaud P 《Cardiovascular and interventional radiology》2012,35(5):1181-1187
Purpose
Retrieval of optional caval filters may be impaired by filter tilting, migration, fracture, or embedding in the IVC wall. The goal of this experimental study was to evaluate a new optional filter, convertible by unlocking and removing the filter head.Methods
Forty-nine Pre-Alp sheep (average weight, 55?kg) were anesthetized. IVC was catheterized via the right femoral vein (n?=?46) or via the internal jugular vein (n?=?3) with a 12.9-F sheath. VenaTech? Convertible? IVC filters were inserted as either permanent filters (n?=?14)?or as filters to be converted. Conversion was immediately after deployment (n?=?19) or delayed after 1, 3, or 6?months (n?=?20). Filter delivery, deployment, and conversion with measurement of migration and tilting were evaluated by cavography. Incorporation of the filter’s stabilizers and arms in the IVC wall was assessed by gross anatomy.Results
Delivery system insertion, filter release, and immediate conversion were successful in all cases. Delayed conversion was completed in all but one sheep, due to insufficient snare tension. Complimentary balloon-catheter inflation was required in 12 of 20 delayed conversions to achieve filter opening. In all 49 sheep, no thrombosis, migration, or significant tilting occurred. Within 4?weeks of conversion, the filter’s stabilizers and arms were incorporated into the IVC wall. Upon removal, the filter head was free of intimal growth.Conclusions
The VenaTech? Convertible? optional IVC filter was successfully implanted in all sheep with no migration or tilting. Conversion at various dates by filter head removal was feasible in all but one case. 相似文献3.
Sadaf A Rasuli P Olivier A Hadziomerovic A French GJ Aquino J O'Kelly K Al-Mutairi B 《Journal of vascular and interventional radiology : JVIR》2007,18(11):1447-1450
This report describes transmural penetration of the inferior vena cava (IVC) by a newly introduced IVC filter within 9 days of its placement. A computed tomographic study demonstrated filter penetration with one of the primary struts lodging in the uncinate process of the pancreas. Because of the close resemblance of this new filter to another filter that has not been associated with penetration injuries, the key differences between the two designs were examined and the determination was made that the new filter, unlike the older one, has unprotected primary struts. Only filters with an unprotected primary strut design have been associated with penetration injuries such as the one described in this case. 相似文献
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Joshua D. Dowell Daniel Wagner Eric Elliott Vedat O. Yildiz Xueliang Pan 《Cardiovascular and interventional radiology》2016,39(2):218-226
Purpose
To identify factors associated with advanced inferior vena cava filter (IVCF) retrieval to raise awareness on technical considerations, retrieval efficiency, and patient safety.Materials and Methods
A single-center retrospective review was performed of 203 consecutive retrievable IVC filters placed between 2007 and 2014. Attempted retrievals were classified as advanced if the routine “snare and sheath” technique was initially unsuccessful after multiple attempts, or an alternate endovascular maneuver or access site was utilized. Patient and filter characteristics were recorded.Results
203 attempted retrievals were reviewed (48.7 % male, 51.2 % female, mean age 52.7 years, mean dwell time 109 days). Advanced retrievals were observed in 20 patients (9.8 %) (15 females, 5 males). Fluoroscopy time (p ≤ 0.01, 34.3 ± 21.1 and 5.3 ± 4.5 min for advanced retrievals and routine retrievals respectively, same below), gender (p = 0.031), and retrieval tilt angle (p ≤ 0.01, 5.7 ± 5.10° vs. 11.9 ± 11.03°) were associated with advanced retrievals. Females were 3.16 times more likely to have an advanced retrieval performed than males with a significantly higher tilt angle in those with advanced retrieval. History of cancer (p = 0.502), dwell time (p = 0.916), retrieval caval diameter (p = 0.053), placement caval diameter (p = 0.365), filter type (p = 0.710), strut perforation (p = 0.506), placement tilt angle (p = 0.311), and age (p = 0.558) were not found significantly associated with advanced retrievals.Conclusions
Women are at increased risk for advanced filter retrieval secondary to a significant change in filter tilt over time compared to men, independent of filter type or competing demographic or filter risks, likely placing them at increased risk for higher procedural fluoroscopy times.6.
Sanjeeva P. Kalva Theodore C. Marentis Kalpana Yeddula Bhanusupriya Somarouthu Stephan Wicky Michael S. Stecker 《Cardiovascular and interventional radiology》2011,34(2):331-337
Purpose
To assess the long-term safety and effectiveness of the OptEase inferior vena cava (IVC) filter. 相似文献7.
Kutlu R Alkan A Sigirci A Altinok T Yildirim Z 《Cardiovascular and interventional radiology》2003,26(5):492-495
The decision to implant vena cava filters, either temporary or permanent, is difficult in young patients. We present the case of a young man with pulmonary embolism in whom temporary and permanent inferior vena cava filters were implanted. The decision process is discussed in relation to the current literature. 相似文献
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Jeffrey Forris Beecham Chick Alexandria Jo J. Matthew Meadows Steven D. Abramowitz Minhaj S. Khaja Kyle J. Cooper David M. Williams 《Journal of vascular and interventional radiology : JVIR》2017,28(7):933-939
Purpose
To report technical success, outcomes, and patency of iliocaval stent reconstruction for inferior vena cava (IVC) filter–bearing iliocaval thrombosis.Materials and Methods
A total of 120 patients with 123 IVC filters and symptomatic iliocaval thrombosis underwent stent reconstruction. Mean patient age was 55 years (range, 19-88 y). Filters included 70 (57%) retrievable and 53 (43%) permanent filters. Symptoms included lower extremity swelling or pain (n = 93), ulcers (n = 8), phlegmasia (n = 7), back pain (n = 5), shortness of breath (n = 4), worsening renal function (n = 2), and stenosis identified during translumbar catheter placement (n = 1). Clinical success was defined as decrease in clinical, etiology, anatomy, and pathophysiology (CEAP) score of at least 1; resolution of presenting symptoms; or normalization of renal function in patients with juxtarenal or suprarenal thrombosis on presentation. Technical aspects of reconstruction, technical success, complications, 6-month clinical response, and 6-, 12-, and 24-month primary, primary-assisted, and secondary stent patency rates were recorded.Results
Stent reconstruction was technically successful in all 120 patients, 63 of whom (53%) underwent thrombolysis. Thirty filters (24%) were retrieved, and 93 (76%) were excluded with stent placement across the indwelling filter. Six minor and 2 major complications occurred. Clinical success was achieved in 115 patients (96%) at 6 months. Six-, 12-, and 24-month primary iliocaval stent patency rates were 96.4%, 94.8%, and 87.2%, respectively. Twenty-four month primary-assisted and secondary patency rates were 90.3% and 94.2%, respectively.Conclusions
Iliocaval stent reconstruction is an effective treatment for filter-associated thrombosis with 100% technical success and 96% clinical success at 6 months. Technical and clinical outcomes in patients who underwent filter retrieval versus filter exclusion were similar. 相似文献9.
Stacey CS Manhire AR Rose DH Bishop MC 《Cardiovascular and interventional radiology》2004,27(1):61-63
We report a case of symptomatic hydronephrosis
caused by transcaval penetration of a Birds Nest filter. Perforation
of the wall of the inferior vena cava (IVC) following insertion of a
caval filter is a well-recognized complication. Whilst two cases of
hydronephrosis have been described with Greenfield filters, no case
involving a Birds Nest filter has been reported previously. 相似文献
10.
Objectives
To evaluate the feasibility and efficacy of the retrievable Günther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep vein thrombosis in the perinatal period and to discuss the technical demands associated with the filter's implantation and retrieval.Methods
Between 1996 until 2007, eight women (mean age 27.4 years, range 20–42 years) with acute deep iliofemoral venous thrombosis in the perinatal period of pregnancy and increased risk of pulmonary embolism during delivery were indicated for retrievable Günther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach.Results
The Günther Tulip Vena Cava Filter was implanted suprarenally in all patients on the day of caesarean delivery. In follow-up cavograms performed just before planned filter removal, no embolus was seen in the filter in any patient. In all patients the filter was retrieved without complications on the 12th day after implantation.Conclusions
Retrievable Günther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications. 相似文献11.
Günther Tulip Retrievable Vena Cava Filter: results from the Registry of the Canadian Interventional Radiology Association 总被引:3,自引:0,他引:3
Millward SF Oliva VL Bell SD Valenti DA Rasuli P Asch M Hadziomerovic A Kachura JR 《Journal of vascular and interventional radiology : JVIR》2001,12(9):1053-1058
PURPOSE: To report data collected by the Canadian Registry of the Günther Tulip Retrievable Filter (GTF). MATERIALS AND METHODS: Between February 1998 and December 2000, 90 patients at eight hospitals underwent implantation of 91 GTFs. There were 45 male patients and 45 female patients, age 17-88 years, with a mean age of 49 years. Indications for filter placement were pulmonary embolism (PE) or deep vein thrombosis (DVT) with a contraindication to anticoagulation in 83 patients, prophylaxis after massive PE in one, prophylaxis for proximal free-floating thrombus in one, and prophylaxis with no DVT or PE in six patients (major trauma, n = 4; high preoperative risk, n = 2). GTF retrieval was attempted in selected patients from a right internal jugular vein approach. RESULTS: One GTF was inadvertently placed in the right iliac vein and could not be retrieved. There were no other major placement complications. GTF retrieval was attempted in 52 patients (53 GTFs); 52 GTFs were successfully retrieved from 51 patients. Implantation times were 2-25 days (mean, 9 d). Of these 51 patients, 37 underwent follow-up for 5-420 days (mean, 103 d) after filter retrieval. Four patients (8% of retrieved GTFs) required reinsertion of a permanent filter 17-167 days (mean, 78 d) after GTF retrieval as a result of bleeding from anticoagulation (n = 2) or because the patient required further surgery (n = 2). One other patient had recurrent DVT 230 days after retrieval; no PE or other complication was documented in the retrieval group. GTFs were not retrieved from 39 patients for various reasons. Of these 39 patients, 25 underwent follow-up 7-420 days (mean, 85 d) after filter placement. Two patients developed filter occlusion (5%); no other complications were documented. CONCLUSION: The GTF has a broad range of utility: it can be used as a permanent filter or retrieved after implantation periods of 15 days and possibly longer. However, indications for retrieval require further study, as does the maximum implantation time. 相似文献
12.
Objective
To determine whether the introducer curving technique is useful in decreasing the degree of tilting of transfemoral Tulip filters.Materials and Methods
The study sample group consisted of 108 patients with deep vein thrombosis who were enrolled and planned to undergo thrombolysis, and who accepted transfemoral Tulip filter insertion procedure. The patients were randomly divided into Group C and Group T. The introducer curving technique was Adopted in Group T. The post-implantation filter tilting angle (ACF) was measured in an anteroposterior projection. The retrieval hook adhering to the vascular wall was measured via tangential cavogram during retrieval.Results
The overall average ACF was 5.8 ± 4.14 degrees. In Group C, the average ACF was 7.1 ± 4.52 degrees. In Group T, the average ACF was 4.4 ± 3.20 degrees. The groups displayed a statistically significant difference (t = 3.573, p = 0.001) in ACF. Additionally, the difference of ACF between the left and right approaches turned out to be statistically significant (7.1 ± 4.59 vs. 5.1 ± 3.82, t = 2.301, p = 0.023). The proportion of severe tilt (ACF ≥ 10°) in Group T was significantly lower than that in Group C (9.3% vs. 24.1%, χ2 = 4.267, p = 0.039). Between the groups, the difference in the rate of the retrieval hook adhering to the vascular wall was also statistically significant (2.9% vs. 24.2%, χ2 = 5.030, p = 0.025).Conclusion
The introducer curving technique appears to minimize the incidence and extent of transfemoral Tulip filter tilting. 相似文献13.
Michael D. Dake Timothy P. Murphy Albrecht H. Krämer Michael D. Darcy Luke E. Sewall Michael A. Curi Matthew S. Johnson Frank Arena James L. Swischuk Gary M. Ansel Mitchell J. Silver Souheil Saddekni Jayson S. Brower Robert Mendes 《Journal of vascular and interventional radiology : JVIR》2018,29(10):1350-1361.e4
Purpose
To prospectively assess the Sentry bioconvertible inferior vena cava (IVC) filter in patients requiring temporary protection against pulmonary embolism (PE).Materials and Methods
At 23 sites, 129 patients with documented deep vein thrombosis (DVT) or PE, or at temporary risk of developing DVT or PE, unable to use anticoagulation were enrolled. The primary end point was clinical success, including successful filter deployment, freedom from new symptomatic PE through 60 days before filter bioconversion, and 6-month freedom from filter-related complications. Patients were monitored by means of radiography, computerized tomography (CT), and CT venography to assess filtering configuration through 60 days, filter bioconversion, and incidence of PE and filter-related complications through 12 months.Results
Clinical success was achieved in 111 of 114 evaluable patients (97.4%, 95% confidence interval [CI] 92.5%–99.1%). The rate of freedom from new symptomatic PE through 60 days was 100% (n = 129, 95% CI 97.1%–100.0%), and there were no cases of PE through 12 months for either therapeutic or prophylactic indications. Two patients (1.6%) developed symptomatic caval thrombosis during the first month; neither experienced recurrence after successful interventions. There was no filter tilting, migration, embolization, fracture, or caval perforation by the filter, and no filter-related death through 12 months. Filter bioconversion was successful for 95.7% (110/115) at 6 months and for 96.4% (106/110) at 12 months.Conclusions
The Sentry IVC filter provided safe and effective protection against PE, with a high rate of intended bioconversion and a low rate of device-related complications, through 12 months of imaging-intense follow-up. 相似文献14.
Eric D. McLoney Venkatesh P. Krishnasamy Jordan C. Castle Xiangyu Yang Gregory Guy 《Journal of vascular and interventional radiology : JVIR》2013,24(11):1723-1729
PurposeTo evaluate and compare the rates of complications on follow-up computed tomography (CT) studies of patients with Celect, Günther Tulip, and Greenfield inferior vena cava (IVC) filters.Materials and MethodsRetrospective review of CT studies obtained 0–1,987 days after infrarenal placement of an IVC filter identified 255 Celect, 160 Tulip, and 50 Greenfield filters. Follow-up CT studies were independently evaluated by two observers for IVC perforation, contact with adjacent organs, and filter fracture. Multivariate analysis was performed to identify factors associated with higher rates of IVC perforation, including age, IVC diameter, sex, and history of malignancy.ResultsIVC perforation was observed in 126 of 255 Celect filters (49%) with a mean follow-up of 277 days, 69 of 160 Tulip filters (43%) with a mean follow-up of 437 days, and one of 50 Greenfield filters (2%) with a mean follow-up of 286 days. A significantly higher IVC perforation rate was observed in women (45.5%) compared with men (30.8%; P = .002) and in patients with a history of malignancy (43.7%) compared with patients with no history of malignancy (29.9%; P < .001). Filter fracture was rare, observed in two of 255 Celect filters (0.8%), one of 160 Tulip filters (0.6%), and none of 50 Greenfield filters.ConclusionsNo significant difference was observed in IVC perforation rate between Celect and Tulip filters. Greenfield filters had a significantly lower rate of IVC perforation than Celect and Tulip filters. Higher IVC perforation rates were observed in women and patients with a history of malignancy. 相似文献
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The Tempofilter II is a widely used temporary vena cava filter. Its unique design, which includes a long tethering catheter with a subcutaneous anchor, facilitates the deployment and retrieval of the device. Despite this, the Tempofilter II has been used only in the inferior vena cava of patients with lower extremity deep venous thrombosis. In this article, we present a case of superior vena cava filtering using the Tempofilter II in patients with upper extremity deep venous thrombosis. 相似文献
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Victor F. Tapson Joshua P. Hazelton John Myers Claudia Robertson Ramyar Gilani Julie A. Dunn Marko Bukur Martin A. Croce Ann Peick Sonlee West Lawrence Lottenberg Jay Doucet Preston R. Miller Bruce Crookes Rajesh R. Gandhi Chasen A. Croft Anthony Manasia Brian A. Hoey Samuel Z. Goldhaber 《Journal of vascular and interventional radiology : JVIR》2017,28(9):1248-1254
Purpose
To evaluate efficacy and safety of a novel device that combines an inferior vena cava (IVC) filter and central venous catheter (CVC) for prevention of pulmonary embolism (PE) in critically ill patients.Materials and Methods
In a multicenter, prospective, single-arm clinical trial, the device was inserted at the bedside without fluoroscopy and subsequently retrieved before transfer from the intensive care unit (ICU). The primary efficacy endpoint was freedom from clinically significant PE or fatal PE 72 hours after device removal or discharge, whichever occurred first. Secondary endpoints were incidence of acute proximal deep venous thrombosis (DVT), catheter-related thrombosis, catheter-related bloodstream infections, major bleeding events, and clinically significant thrombus (occupying > 25% of volume of filter) detected by cavography before retrieval.Results
The device was placed in 163 critically ill patients with contraindications to anticoagulation; 151 (93%) were critically ill trauma patients, 129 (85%) had head or spine trauma, and 102 (79%) had intracranial bleeding. The primary efficacy endpoint was achieved for all 163 (100%) patients (95% confidence interval [CI], 97.8%–100%, P < .01). Diagnosis of new or worsening acute proximal DVT was time dependent with 11 (7%) occurring during the first 7 days. There were no (0%) catheter-related bloodstream infections. There were 5 (3.1%) major bleeding events. Significant thrombus in the IVC filter occurred in 14 (8.6%) patients. Prophylactic anticoagulation was not initiated for a mean of 5.5 days ± 4.3 after ICU admission.Conclusions
This novel device prevented clinically significant and fatal PE among critically ill trauma patients with low risk of complications. 相似文献17.
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May–Thurner syndrome is known as compression of the left common iliac vein by the right common iliac artery. We describe a
case of an atypical compression of the inferior vena cava by the right common iliac artery secondary to a high aortic bifurcation.
Despite an extensive collateral network, there was a significant venous gradient between the iliac veins and the inferior
vena cava above the compression. After stenting the venous pressure gradient disappeared. Follow-up 4 months later revealed
a good clinical response with a patent stent. 相似文献
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Younghoon Cho Dong Il Gwon Gi-Young Ko Heung Kyu Ko Jin Hyoung Kim Ji Hoon Shin Hyun-Ki Yoon Kyu-Bo Sung 《Korean journal of radiology》2014,15(1):87-94
Objective
To evaluate the safety and efficacy of unilateral covered stent placement in patients with malignant superior vena cava (SVC) syndrome.Materials and Methods
Between October 2008 and November 2012, expanded polytetrafluoroethylene-covered stent placement for malignant SVC syndrome was performed in 40 consecutive patients (35 men and five women; mean age, 61.4 years; range, 35-81 years). All covered stents were unilaterally placed within the SVC or across the venous confluence when needed to relieve venous obstruction and prevent tumor overgrowth, regardless of patency of contralateral brachiocephalic veins.Results
Stent placement was technically successful in all patients. There were no major complications. Of the 37 patients symptomatic prior to stent placement, 34 (92%) experienced complete symptomatic relief 1-8 days after stent placement. Of the 29 patients who underwent covered stent placement across the venous confluence, nine patients had patent contralateral brachiocephalic veins prior to stent placement. However, no sign of SVC obstruction or contralateral upper extremity venous thrombosis was observed during the follow-up period. Kaplan-Meier analysis revealed median patient survival of 163 days. Stent occlusion occurred in four (10%) of 40 patents. Cumulative stent patency rates at 1, 3, 6, and 12 months were 95%, 92%, 86%, and 86%, respectively.Conclusion
Unilateral covered stent placement appears to be a safe and effective method for treating malignant SVC syndrome, despite the location of SVC occlusion. 相似文献20.
《Journal of vascular and interventional radiology : JVIR》2014,25(1):63-69
A 29-year-old woman with acute iliofemorocaval thrombosis was discovered to have suprarenal caval agenesis with azygous continuation, hepatic congestion, and fibrosis as a result of chronic Budd–Chiari syndrome. Three staged procedures were performed: pharmacomechanical thrombolysis of acute thromboses, transfemoral liver biopsy and hemodynamic assessment, and percutaneous endovascular creation of a “neocava” lined with endografts. Symptomatic improvement and patency were maintained at 12-week follow-up. 相似文献