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目的回顾导管辅助法回收贴壁Tulip下腔静脉滤器的技巧。方法 2007年11月至2009年10月收治肺动脉栓塞及急性下肢深静脉血栓形成(DVT)患者95例,对其中6例(男4例,女2例;年龄24～71岁,平均43.7岁)单纯捕捉器法未能成功捕获滤器的患者,采用导管辅助法行下腔静脉滤器取出术。具体是在下腔静脉造影证实滤器回收钩贴壁后,使用导管结合鹅颈捕捉器剥离粘连、回收滤器。术后对患者给予抗凝、抗炎治疗3～5 d。随访4～12个月,复查血管超声及肺动脉3D CTA。结果成功回收6例患者的Tulip滤器。采用的操作技术包括导管扭转(1例)、导管成襻(1例)、导管-捕捉器成襻(4例)。回收过程平均用时40.5 min(17～78 min)。滤器在体内留置时间平均为46.7 d(14～80 d)。随访期间未出现下肢静脉血栓形成及肺动脉栓塞。结论导管辅助法对于贴壁Tulip滤器的回收率较高,可明显提高Tulip下腔静脉滤器回收成功率。
Objective To review the technique of catheter-assisted recovery of adherent Tulip IVC filters. Methods From November 2007 to October 2009, 95 patients with pulmonary embolism and acute lower extremity deep vein thrombosis (DVT) were enrolled. Among them, 6 patients (4 males and 2 females; aged 24-71 years, mean 43.7 years) Pure trap method failed to capture the filter in patients with catheter-assisted approach to remove the inferior vena cava filter. Specifically in the inferior vena cava angiography confirmed after the recovery hook hook attached to the wall, the catheter with a gooseneck trap stripping adhesions, recovery filter. Patients were given anticoagulation, anti-inflammatory treatment of 3 ~ 5 d. Follow-up 4 to 12 months, review of vascular ultrasound and pulmonary artery 3D CTA. Results Six Tulip filters were successfully recovered. The operating techniques used included catheter torsion (1 case), catheterization (1 case) and catheter-catcher implantation (case 4). The average recovery time is 40.5 minutes (17 ~ 78 minutes). The average retention time of the filter in the body was 46.7 days (14 ~ 80 days). No lower extremity venous thrombosis and pulmonary embolism occurred during follow-up. Conclusion The catheter-assisted method has a higher recovery rate for the adherent Tulip filter and can significantly improve the recovery rate of the Tulip IVC filter.