Abstract：Objective: To evaluate the clinical efficacy and safety of mechanical thrombectomy(PMT) in the treatment of inferior vena cava filter-related thrombosis. Methods: A total of 14 patients with inferior vena cava filter-related thrombosis were included in the study from January 2017 to March 2019 retrospectively. Inferior vena cava filters had been implanted in all patients from 12 to 14 days. Data including the changes of hemoglobin and renal function, asymptomatic pulmonary embolism, the grade of thrombolytic clearance rate, successful recovery of filter and injury of inferior vena cava were compared. Results: There was no significant difference in the level of hemoglobin and renal function before and after PMT. No symptomatic pulmonary embolism occurred. Twelve patients(85.71%) had grade Ⅲ and two patients(14.29%) had grade Ⅱ thrombus clearance after PMT, combined CDT treatment the thrombus clearance reached grade Ⅲ. All patients successfully recovered filters without inferior vena cava injury. Conclusions: PMT is an effective and safe treatment method in patients with inferior vena cava filter-related thrombosis, thereby the success rate of filter recovery can be improved.
迟 源，马羽佳，王子文，刘兆玉. 机械性血栓清除术治疗下腔静脉滤器相关血栓的疗效评价[J]. 中国临床医学影像杂志, 2020, 31(3): 208-211.
CHI Yuan, MA Yu-jia, WANG Zi-wen, LIU Zhao-yu. The effect of percutaneous mechanical thrombectomy in patients with inferior vena cava filter-related thrombosis. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(3): 208-211.
[1]Han B, Ge GQ, Zhang HG, et al. Prevention of pulmonary embolisms associated with vena cava filter implantation[J]. Phlebology, 2015, 30(1): 24-31.
[2]Schleich JM, Morla O, Laurent M, et al. Long-term follow-up of percutaneous vena cava filters: a prospective study in 100 consecutive patients[J]. Eur J Vasc Endovasc Surg, 2001, 21(5): 450-457.
[3]The PREPIC Study Group. Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC randomized study[J]. Circulation, 2005, 112(3): 416-422.
[4]Hidaka N, Hachisuga M, Tsukimori K, et al. Intrapartum placement of an inferior vena cava filter for a woman with hereditary antithrombin Ⅲ deficiency: Its role in the prevention of fatal pulmonary embolism[J]. J Obslet Gynecol, 2008, 34(2): 95-99.
[5]周立兴，郭曙光，尹存平，等. 可回收滤器回收并发症导致开腹手术一例[J]. 中华普通外科杂志，2013，28（10）：812-813.
[6]Zatevakhin II, Shipovsky VN, Barzaeva MA. Remote results of implantation of cava filters: analysis of errors and complications[J]. Angiol Sosud Khir, 2015, 21(2): 53-58.
[7]Sarosiek S, Crowther M, Sloan JM. Indications, complications, and management of inferior vena cava filters: the experiencein 952 patients at an academic hospital with a level Ⅰ trauma center[J]. JAMA Intern Med, 2013, 173(7): 513-517.
[8]Cynamon J, Stein EG, Dym RJ, et al. A new method for aggressive management of deep vein thrombosis: retrospective study of the power pulse technique[J]. J Vasc Interv Radiol, 2006, 17(6): 1043-1049.
[9]Laganà D, Carrafiello G, Lumia D, et al. Removable vena cava filter: single center experience with a single device[J]. Radiol Med, 2013, 118(5): 816-825.
[10]Gyang E, Zayed M, Harris EJ, et al. Factors impacting follow-up care after placement of temporary inferior vena cava filters[J]. J Vasc Surg, 2013, 58(2): 440-445.
[11]Jia Z, Wu A, Tam M, et al. Caval penetration by inferior vena cava filters: A systematic literature review of clinical significance and management[J]. Circulation, 2015, 132(10): 944-952.
[12]Chassin-Trubert L, Prousse G, Ozdemir BA, et al. Filter-associated inferior vena cava thrombosis with duodenal perforation: case report and literature review[J]. Ann Vasc Surg, 2019, 58(11): 30124.
[13]张蕴鑫，刘建龙，贾伟，等. 腹腔镜辅助下腔静脉滤器取出术一例[J]. 中华血管外科杂志，2018，3（4）：245-246.
[14]中华医学会放射学分会介入学组. 下腔静脉滤器植入术和取出术规范的专家共识[J]. 中华放射学杂志，2011，45（3）：297-300.
[15]Yan BP, Kiernan TJ, Gupta V, et al. Combined pharmacomechanical thrombectomy for acute inferior vena cava filter thrombosis[J]. Cardiovasc Revasc Med, 2008, 9(1): 36-40.
[16]Sakatani A, Nishio M, Kume K, et al. Rivaroxaban for fully occlusive inferior vena cava filter thrombus[J]. Circul J, 2019, (2): 1141.
[17]Jessica M, Andreol I, Bartley G, et al. Inferior vena cava filter-related thrombus/deep vein thrombosis: data and management[J]. Semin Intervent Radiol, 2016, 33(2): 101-104.
[18]施万印，陈亮，刘长建，等. 血管内介入治疗滤器源性下腔-髂静脉长段阻塞8例[J]. 介入放射学杂志，2017，26（11）：978-982.
[19]宋进华，施万印，赵伯翔，等. 机械性血栓清除装置在治疗急性下腔静脉滤过器相关性血栓中的应用[J]. 临床放射学杂志，2018，37（7）：1190-1195.
[20]Jeyabalan G, Saba S, Baril DT, et al. Brady arrhythmias during rheolytic pharmacomechanical thrombectomy for deep vein thrombosis[J]. J Endovasc Ther, 2010, 17(3): 416-422.
[21]Saha A, Timothy J, Sahil P, et al. The use of angiovac thrombectomy in IVC filter-associated inferior vena cava thrombosis[J]. JACC Cardiovasc Interv, 2019, 7(18): 32214.
[22]中国医师协会介入医师分会，中华医学会放射学分会介入专业委员会，中国静脉介入联盟. 下肢深静脉血栓形成介入治疗规范的专家共识（第2版）[J]. 介入放射学杂志，2019，28（1）：1-10.
