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目的探讨在下肢深静脉血栓(DVT)治疗过程中不同滤器回收钩贴壁回收困难时取出的技巧和策略。方法2011年1月至2016年4月南通大学第二附属医院介入科收治并行介入治疗DVT患者486例,放置静脉滤器461枚,发生65例滤器倾斜、回收钩贴壁,其中OptEase 53例,Aegisy 12例。分别采用常规套取法、上端撬动滤器法、硬导丝辅助鹅颈抓捕器圈套法、鹅颈抓捕器加硬导丝拉动钩端法、导丝通过滤器钩端中心法将下腔静脉可回收滤器取出。结果 53例OptEase滤器回收钩贴壁患者,采用常规套取法取出7例,上端撬动滤器法取出5例,硬导丝辅助鹅颈抓捕器圈套法取出38例,鹅颈抓捕器加硬导丝拉动钩端法取出3例;12例Aegisy滤器回收钩贴壁患者,采用常规套取法取出2例,导丝通过滤器下钩端中心法取出10例。结论 Aegisy滤器取出困难时,导丝通过滤器钩端中心法最实用;OptEase滤器取出困难时,硬导丝辅助鹅颈抓捕器圈套钩端法简便、有效、成功率高。
Objective To explore the skills and tactics of removal when different filter recycle hooks attached to the wall of the lower extremity deep vein thrombosis (DVT) are difficult to recover. Methods From January 2011 to April 2016, 486 cases of DVT were treated by the interventional department of the Second Affiliated Hospital of Nantong University. 461 venous filters were placed and 65 filters were tilted. The hooks were attached to the wall, including 53 cases of OptEase, 12 cases. Respectively using the conventional sleeve method, the upper pry filter method, hard wire assisted gooseneck trap trap method, gooseneck catcher plus hard wire pulling hook end method, guide wire through the hook end of the center of the filter will be the lower chamber Vein recoverable filter removed. Results 53 cases of OptEase filter hook recovery attached to the wall of the patients, the use of conventional catheter removal in 7 cases, the upper end of the leaking filter removed 5 cases, hard wire assisted Gooseneck trap trap removed 38 cases gooseneck arrest Hard guide wire pulled the hook end method to remove 3 cases; 12 cases of Aegisy filter recovery hook sticking wall patients, using conventional method to remove 2 cases, guide wire through the hook under the center of the catheter removed in 10 cases. Conclusions When the Aegisy filter is difficult to remove, the center of the guide wire through the filter hook is the most practical method. When the OptEase filter is difficult to remove, it is simple, effective and successful to use the hard-wire auxiliary gooseneck trap.