Clinical Study of Vena Cava Filter in Preventing from Pulmonary Embolism Induced by Lower Extremity Deep Venous Thrombosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HAN Bing , GE Changqing , ZHANG Hongguang , ZHOU Chenguang , JI Guohui , YANG Zheng , ZHANG Liang

Department of Vascular Surgery， The Second Hospital of Baoding City， Baoding 071051， Hebei Province， China;

Corresponding author：

Keywords：

Deep venous thrombosis; Pulmonary embolism; Vena cava filter; Indication; Patency rate

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Objective 　To summarize the probability of pulmonary embolism （PE） induced by lower extremity deep venous thrombosis （DVT） and investigate the role of vena cava filter （VCF） in preventing from PE.
Methods　 The clinical data of 1 058 patients with lower extremity DVT from January 2005 to January 2012 were analyzed retrospectively.
Results 　The PE rate was 3.21% （34/1 058） and the death rate was 1.42% （15/1 058） in 1 058 patients with lower extremity DVT. The VCF was implanted in 171 of 1 058 patients. The VCFs of 151 patients were implanted from femoral vein， 20 patients were implanted from jugular vein. The PE rates were 3.61% （32/887） and 1.17% （2/171） and the death rates were 1.69% （15/887） and 0 （0/171） in patients without VCF and with VCF， respectively. Both of them occurred in the first ten days. PE could keep as long as 35 d. The PE rate and death rate in the patients without VCF were significantly higher than those in the patients with VCF （P＜0.01）. The PE rates and death rates in both lower extremities DVT were higher than those in patients with the right and left ones （P＜0.05）， which in the right lower extremity were higher than those in the left one （P＜0.05）. The PE rate and death rate in the patients with lower extremity DVT combined with vena cava thrombosis were significantly higher than those in the patients with central type （P＜0.05）， which in the central type were significantly higher than those in the peripheral type （P＜0.05）， there were no significant differences between peripheral type and mixed pattern. The follow-up time was from 1 month to 7 years with （39±19） months， the patency rate of VCF was 98.7%. There were no filter migration， declination， and failure of expansion.
Conclusions 　VCF can prevent from PE effectively， but the indications must be controlled.

Citation： HAN Bing,GE Changqing,ZHANG Hongguang,ZHOU Chenguang,JI Guohui,YANG Zheng,ZHANG Liang. Clinical Study of Vena Cava Filter in Preventing from Pulmonary Embolism Induced by Lower Extremity Deep Venous Thrombosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(11): 1156-1162. doi: Copy

1.	Sarani B， Chun A， Venbrux A. Role of optional （retrievable） IVC filters in surgical patients at risk for venous thromboembolic disease[J]. J Am Coll Surg， 2005， 201(6)：957-964.
2.	葛长青，韩冰，张宏光，等. 下肢深静脉-下腔静脉远心端血栓形成治疗的临床研究[J/OL]. 中华临床医师杂志(电子版)， 2011， 5(9)：2780-2782.
3.	韩冰，张磊，张宏光，等. 下腔静脉滤器植入、溶栓、手术治疗下肢深静脉血栓形成[J]. 中国普通外科杂志， 2004， 13(1)：6-8.
4.	李博，余朝文. 下腔静脉滤器预防下肢DVT并发肺栓塞的现状[J]. 中华全科医学， 2012， 10(1)：91-93.
5.	Nazir SA， Ganeshan A， Nazir S， et al. Endovascular treatment options in the management of lower limb deep venous thrombosis[J]. Cardiovasc Intervent Radiol， 2009， 32(5)：861-876.
6.	卞栋. 22例急性下肢深静脉血栓形成的外科治疗体会[J]. 中华全科医学， 2010， 8(6)：719-720.
7.	关海涛，邹英华. 下腔静脉滤器应用回顾及展望[J]. 中国介入影像与治疗学， 2010， 7(4)：468-471.
8.	Flaim A， Brennan M， Safranek S. Do endovascular filters prevent PE as effectively as anticoagulants in patients with DVT?[J]. J Fam Pract， 2010， 59(2)：121-122.
9.	杨春明. 外科学原理与实践[M]. 第2版. 北京：人民卫生出版社， 2003：1290-1300.
10.	罗华，梁瑛. 肺血栓栓塞症的诊疗现状及展望[J]. 中华现代内科学杂志， 2008， 4(5)：5.
11.	Hammond CJ， Bakshi DR， Currie RJ， et al. Audit of the use of IVC filters in the UK：experience from three centres over 12 years[J]. Clin Radiol， 2009， 64(5)：502-510.
12.	李国剑，杨国凯，何晓明，等. 下腔静脉滤器在治疗下肢深静脉血栓中的应用[J]. 中国普外基础与临床杂志， 2009， 16(11)：922-924.
13.	王玉琦，史振宇. 我国血管外科的现状与展望[J]. 中国普外基础与临床杂志， 2008， 15(6)：387-389.
14.	马玉奎，赵纪春，胡志，等. 下肢深静脉血栓形成的诊断及综合治疗[J]. 中国普外基础与临床杂志， 2008， 15(1)：56-58.
15.	张柏根. 下肢深静脉血栓形成治疗和预后的几个问题[J]. 中华普通外科杂志， 2006， 21(2)：81-83.
16.	Allen TL， Carter JL， Morris BJ， et al. Retrievable vena cava filters in trauma patients for high-risk prophylaxis and prevention of pulmonary embolism[J]. Am J Surg， 2005， 189(6)：656-661.
17.	Stefanidis D， Paton BL， Jacobs DG， et al. Extended interval for retrieval of vena cava filters is safe and may maximize protection against pulmonary embolism[J]. Am J Surg， 2006， 192(6)：789-794.
18.	Barretl J， Hamilton W. Malignancy and deep vein thrombosis[J]. Br J Gen Pract， 2006， 56(532)：886.
19.	Proctor MC， Greenfield LJ. Form and function of vena cavafilters：how do optional filters measure up?[J]. Vascular， 2008， 16(1)：10-16.
20.	Sing RF， Camp SM， Heniford BT， et al. Timing of pulmonary emboli after trauma：implications for retrievable vena cava filters[J]. J Trauma， 2006， 60(4)： 732-734.
21.	郑江华，武国，朱彦彬，等. 腔静脉滤器置入联合导管直接溶栓治疗下肢深静脉血栓形成临床分析[J]. 中国普外基础与临床杂志， 2010， 17(7)：679-682.
22.	张精勇，金星，吴学君，等. 滤器保护下置管溶栓治疗下肢深静脉血栓形成临床总结[J]. 中国实用外科杂志， 2006， 26(10)：774-776.
23.	Alesh I， Kayali F， Stein PD. Catheter-directed thrombolysis(intrathrombus injection) in treatment of deep venous thrombosis：a systematic review[J]. Catheter Cardiovasc Interv， 2007， 70(1)：143-148.
24.	Athanasoulis CA， Kaufman JA， Halpern EF， et al. Inferior vena caval filters：review of a 26-year single-center clinical experience[J]. Radiology， 2000， 216(1)：54-66.
25.	PREPIC Study Group. Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonaryembolism：the PREPIC (Prevention du Risque d’Embolie Pulmonaire par Interruption Cave) randomized study[J]. Circulation， 2005， 112(3)：416-422.
26.	Hidaka N， Hachisuga M， Tsukimori K， et al. Intrapartum placement of an inferior vena cava filter for a woman with hereditary antithrombinⅢdeficiency：its role in the prevention of fatal pulmonary embolism[J]. J Obstet Gynaecol Res， 2008， 34(1)：95-99.

1. Sarani B， Chun A， Venbrux A. Role of optional （retrievable） IVC filters in surgical patients at risk for venous thromboembolic disease[J]. J Am Coll Surg， 2005， 201(6)：957-964.
2. 葛长青，韩冰，张宏光，等. 下肢深静脉-下腔静脉远心端血栓形成治疗的临床研究[J/OL]. 中华临床医师杂志(电子版)， 2011， 5(9)：2780-2782.
3. 韩冰，张磊，张宏光，等. 下腔静脉滤器植入、溶栓、手术治疗下肢深静脉血栓形成[J]. 中国普通外科杂志， 2004， 13(1)：6-8.
4. 李博，余朝文. 下腔静脉滤器预防下肢DVT并发肺栓塞的现状[J]. 中华全科医学， 2012， 10(1)：91-93.
5. Nazir SA， Ganeshan A， Nazir S， et al. Endovascular treatment options in the management of lower limb deep venous thrombosis[J]. Cardiovasc Intervent Radiol， 2009， 32(5)：861-876.
6. 卞栋. 22例急性下肢深静脉血栓形成的外科治疗体会[J]. 中华全科医学， 2010， 8(6)：719-720.
7. 关海涛，邹英华. 下腔静脉滤器应用回顾及展望[J]. 中国介入影像与治疗学， 2010， 7(4)：468-471.
8. Flaim A， Brennan M， Safranek S. Do endovascular filters prevent PE as effectively as anticoagulants in patients with DVT?[J]. J Fam Pract， 2010， 59(2)：121-122.
9. 杨春明. 外科学原理与实践[M]. 第2版. 北京：人民卫生出版社， 2003：1290-1300.
10. 罗华，梁瑛. 肺血栓栓塞症的诊疗现状及展望[J]. 中华现代内科学杂志， 2008， 4(5)：5.
11. Hammond CJ， Bakshi DR， Currie RJ， et al. Audit of the use of IVC filters in the UK：experience from three centres over 12 years[J]. Clin Radiol， 2009， 64(5)：502-510.
12. 李国剑，杨国凯，何晓明，等. 下腔静脉滤器在治疗下肢深静脉血栓中的应用[J]. 中国普外基础与临床杂志， 2009， 16(11)：922-924.
13. 王玉琦，史振宇. 我国血管外科的现状与展望[J]. 中国普外基础与临床杂志， 2008， 15(6)：387-389.
14. 马玉奎，赵纪春，胡志，等. 下肢深静脉血栓形成的诊断及综合治疗[J]. 中国普外基础与临床杂志， 2008， 15(1)：56-58.
15. 张柏根. 下肢深静脉血栓形成治疗和预后的几个问题[J]. 中华普通外科杂志， 2006， 21(2)：81-83.
16. Allen TL， Carter JL， Morris BJ， et al. Retrievable vena cava filters in trauma patients for high-risk prophylaxis and prevention of pulmonary embolism[J]. Am J Surg， 2005， 189(6)：656-661.
17. Stefanidis D， Paton BL， Jacobs DG， et al. Extended interval for retrieval of vena cava filters is safe and may maximize protection against pulmonary embolism[J]. Am J Surg， 2006， 192(6)：789-794.
18. Barretl J， Hamilton W. Malignancy and deep vein thrombosis[J]. Br J Gen Pract， 2006， 56(532)：886.
19. Proctor MC， Greenfield LJ. Form and function of vena cavafilters：how do optional filters measure up?[J]. Vascular， 2008， 16(1)：10-16.
20. Sing RF， Camp SM， Heniford BT， et al. Timing of pulmonary emboli after trauma：implications for retrievable vena cava filters[J]. J Trauma， 2006， 60(4)： 732-734.
21. 郑江华，武国，朱彦彬，等. 腔静脉滤器置入联合导管直接溶栓治疗下肢深静脉血栓形成临床分析[J]. 中国普外基础与临床杂志， 2010， 17(7)：679-682.
22. 张精勇，金星，吴学君，等. 滤器保护下置管溶栓治疗下肢深静脉血栓形成临床总结[J]. 中国实用外科杂志， 2006， 26(10)：774-776.
23. Alesh I， Kayali F， Stein PD. Catheter-directed thrombolysis(intrathrombus injection) in treatment of deep venous thrombosis：a systematic review[J]. Catheter Cardiovasc Interv， 2007， 70(1)：143-148.
24. Athanasoulis CA， Kaufman JA， Halpern EF， et al. Inferior vena caval filters：review of a 26-year single-center clinical experience[J]. Radiology， 2000， 216(1)：54-66.
25. PREPIC Study Group. Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonaryembolism：the PREPIC (Prevention du Risque d’Embolie Pulmonaire par Interruption Cave) randomized study[J]. Circulation， 2005， 112(3)：416-422.
26. Hidaka N， Hachisuga M， Tsukimori K， et al. Intrapartum placement of an inferior vena cava filter for a woman with hereditary antithrombinⅢdeficiency：its role in the prevention of fatal pulmonary embolism[J]. J Obstet Gynaecol Res， 2008， 34(1)：95-99.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Study of Vena Cava Filter in Preventing from Pulmonary Embolism Induced by Lower Extremity Deep Venous Thrombosis

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