曲凡勇　李旺丽

可回收下腔静脉滤器取出术相关并发症探讨

曲凡勇李旺丽

目的探讨可回收下腔静脉滤器取出技巧及出现的相关并发症。方法收集2008年5月—2015年3月接受彩超检查发现下肢深静脉血栓形成并置入可回收滤器的72例病人，对其中的35例溶栓效果良好且无发生肺栓塞风险的病人行下腔静脉滤器取出术。结果35例病人中下腔静脉滤器成功取出33例，取出率94%，其中有3例病人取出滤器后发现滤器内捕获血栓，2例滤器取出过程中及术后造影发现下腔静脉穿孔，1例发生顽固性心律失常，经积极对症处理后未发现症状性肺栓塞及猝死等严重情况。另外2例取出失败后转为永久留置。结论规范、熟练地操作下腔静脉滤器取出术既可以避免下腔静脉滤器长期留置的远期并发症，同时也减少下腔静脉滤器取出术操作中并发症的发生。

下腔静脉滤器；并发症；下肢深静脉血栓；肺栓塞；介入放射学

DOI：10.19300/j.2016.L3655

【Abstract】ObjebtiveTo explore the techniques and related complications of removing retrievable inferior vena cava filter.MethodsFrom May 2008 to March 2015，seventy-two patients with lower limb deep vein thrombosis formation clearly diagnosed by color Doppler ultrasound were imbedded retrievable filter.The inferior vena cava filter was removed from thirty-five cases who had successful thrombolysis and no risk of pulmonary vein thrombosis.ResultsThe inferior vena cava filter was successfully removed in thirty-three of thirty-five（94%）cases.Among the thirty-three cases，three cases revealed capture thrombus inside filter after removal，two cases revealed interior vena cava perforation during removal process and on postoperative angiography，and one case suffered from intractable arrhythmia without pulmonary embolism and sudden death after positive symptomatic treatment.The remain two cases of failed removal turned into permanent indwelling.Conclusion Normative and skilled removal of inferior vena cava filter can avoid long-term complications of chronically indwelling of inferior vena cava filter，and can reduce the occurrence of complications of removing inferior vena cava.

【Key words】Inferiorvenacavafilter；Complication；Deepvenousthrombosis；Pulmonaryembolism；Interventionalradiology

Int J Med Radiol，2016，39（2）：120-122

下腔静脉滤器（inferior vena cava filter，IVCF）置入术使下肢深静脉血栓（deep vein thrombosis，DVT）导致的肺栓塞（pulmonary embolism，PE）发生率降至0.9%～5%［1］，被临床医师公认为是预防PE的安全有效方法。但随着IVCF的广泛应用，多项研究报道，置入体内的下腔静脉滤器可出现不同概率的折断、移位、脱落，下腔静脉内血栓，下腔静脉穿孔等近期及远期并发症［2-5］。在溶栓完毕并保证安全的情况下，IVCF的取出成为减少IVCF置入后上述并发症的良策。但同时也出现了IVCF取出操作的相关并发症。本研究就可回收下腔静脉滤器取出方法及取出术中相关并发症进行探讨分析。……