| Objective: This study was designed to evaluate the efficacy, safity, andcomplications of IVCF placement so as to accumulate experiences andimprove knowledge of the procedure, and finally to make our PEpreventive work better in patients with VTE.Method: Thirty-nine inhospital patients with both deep-vein thrombosis(DVT) (confirmed by vascular ultrasound or vasography) and pulmonaryembolism (PE) (confirmed by pulmonary arteriography, spiral computedtomography (CT) or perfusion lung scanning) were involved in this study.All these patients were hospitalized From Oct 2003 to April 2006, in BaoDi Hospital of Tianjin city. All the patients were divided into two groups.Groupâ… : 19 cases placed a IVCF in addition to standard anticoagulationtreatment; Groupâ…¡: 20 patients only treated with standard anticoagulanttreatment without IVCF placement. Both groups were matched with eachother in general clinical date, and typing of PE as well as treatment ofanticoagulation and fibrelytic therapy. Data on vital status, mortality rateof inhospital and follow-up, recurrent PE and DVT(confirmed by thesame methods as above), and other complications of IVCF such as filter migration, IVC penetration by filter components(confirmed by CT) bycollecting inhospital and follow-up information.Result: 1. Inhospital time: 1 patient died in the filter group; and 7 died inthe no-filter group(P=0.016).2. Follow-up: Symptomatic recurrent PE occurred in 0 patient in thefilter group and 4 patients in the no-filter group(P=0.04); At 1 year, 3patients had died (1patient and 2 patients in the filer and no-filter groups,respectively, P=0.015).3. Complications: During placement, filter declination occurred in 1patient. Some post-procedure complications presented including lowerextremity venous thrombosis, filter migration and IVC penetration. DVTrecurrent occurred in 1 patient in each group; filter migration wasobserved in 1 patient; IVC penetration was noted in 1 patient and thefilter penetrated the abdominal aorta. No patient was believed to havesymptoms as a result of these events. No other complications were foundin both groups.Conclusion: Inhospital time: IVCF reduced total death rate, the deathrate of PE, especially massive PE; Follow-up: IVCF reduced PErecurrent rate and total death rate, as well as DVT recurrent rate.Although these may be some complications, the value of IVCF can't be replaced by any other treatment. |
