腔静脉滤器预防肺栓塞的临床应用

目的:评价置入腔静脉滤器预防因静脉血栓脱落引起肺栓塞的效果和安全性.方法:19例下肢深静脉血栓和1例上肢深静脉血栓患者均置入钛质Bird'snestfilter(BNF).滤器位于双肾静脉水平以下的下腔静脉内或上腔静脉干内.术后分别于1、6、12个月摄胸或腹部平片复查,观察滤器的位置、形态变化.结果:全部滤器经股静脉或右颈内静脉穿刺置入,经右股静脉15例,左股静脉3例,右颈内静脉2例.无严重并发症发生.随访发现2例向头侧移,1例向足侧移位,2例跨度增大,腹部CT发现滤器的2只脚穿透腔静脉壁,未出现任何症状,无1例滤器发生倾斜.无1例发生腔静脉阻塞或复发肺栓塞.结论:置入腔静脉滤器预防肺栓塞是安全、有效的方法.

Percutaneous Transfemoral Placement of Vena Cava Filter to Prevent Pulmonary Embolism

Objective: To evaluate the effectiveness and safety of inserting a vana cava filter to prevent the lung from embolism due to detachment of the thrombus in the extremities.Materials and Methods: Vena cava filters were placed in 19 patients with deep venous thrombosis in the lower extremities and a patient in the upper limb.Bird's nest filter(BNF) was used in 20cases.The filters were placed in IVC at the level below the renal veins or in SVC.At the end of the 1st,6th,and 12th month after the surgery,thoracic or abdominal radiographs were taken to see if there was any displacement or disfiguration of the filter.Results: All the filters were placed though the common femoral veins or the right internal jugular veins percutaneously,right access in 15,left access in 3 and the right internal jugular veins in 2.No serious complications occurred.BNF migrated 3-5mm cephalad in two patients,and 6mm caudally in one patient.The span of the filter was increased in two cases,penetrating intovena cava wall,which was detected by CT scan,the patients remained asymptomatic.No-one BNF was inclined.No VC occlusion or recurrent pulmonary embolism occurred.Conclusion: The VC filter placement is an effective and safe technique in preventing the lung from embolism.