医学
不利影响
下腔静脉
介绍
回顾性队列研究
下腔静脉滤器
病历
停留时间
滤波器(信号处理)
外科
放射科
内科学
血栓形成
家庭医学
计算机视觉
临床心理学
静脉血栓形成
计算机科学
作者
Shelley Leong,Farhad Farzanegan,Mateen Moghbel,Jean Min,Sudhir Rajan,Chi-Mei Liu,Robert Freed,Shaun Ray Han Loh,Maud M. Morshedi,Rich S. Rana,Danny Wang,Gabriel Howles-Banerji,Francis Bolanos,Stephen L. Wang
出处
期刊:American Journal of Roentgenology
[American Roentgen Ray Society]
日期:2023-03-01
卷期号:220 (3): 389-397
被引量:2
摘要
BACKGROUND. Specialized inferior vena cava (IVC) filter referral centers can achieve improved retrieval outcomes, potentially facilitating complex retrievals after long filter dwell times. OBJECTIVE. The purpose of this study was to determine the success rate of complex IVC filter retrievals at a large specialized IVC filter referral center and to identify predictors of adverse events during complex retrievals. METHODS. This retrospective study included patients who underwent complex IVC filter retrieval from March 2014 to June 2018 at a large regional health system with specialized complex retrieval referral centers and interventional radiologists with expertise in such procedures. Complex retrievals methods included a range of loop snare, coaxial sheath, forceps, and snare techniques. Data were collected from the electronic medical record. The success rate of complex retrieval was determined. Factors associated with adverse events during retrieval procedures were explored. RESULTS. The study included 125 patients (51 women, 74 men; mean age, 60 years). The mean filter dwell time at retrieval was 47.5 months (median, 21.8 months). The complex retrieval success rate was 99.2% on the first attempt and 100.0% overall. A total of 11.2% (14/125) of patients experienced an adverse event during retrieval, including 10.4% (13/125) with minor and 0.8% (1/125) with major events. Prolonged dwell time was the only indication for complex retrieval that was significantly associated with adverse events (adverse event rate, 16.7% for patients with this indication vs 5.1% for patients without this indication; p = .04). In multiple regression analysis, the only significant independent predictor of adverse events was a filter dwell time of 5 years or longer (odds ratio, 6.98 [95% CI, 1.64-29.81]; p = .009). CONCLUSION. In a specialized referral system with expertise in complex retrieval methods, high retrieval success rates can be achieved in patients who have filters with long dwell times. Nonetheless, longer dwell times are associated with adverse events during retrieval procedures. CLINICAL IMPACT. The observations support performing early filter retrieval and referring patients who have filters with prolonged dwell times to specialized centers.
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