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目的探讨经颈静脉途径对Günther Tulip可回收式下腔静脉滤器回收的技巧和策略。方法选择2012年1月至2014年12月置入Günther Tulip可回收式下腔静脉滤器后严重倾斜、回收钩贴壁患者25例,采用常规圈套技术无法回收,其中男性17例,女性8例;年龄27~72岁,平均年龄56.2岁。采用导丝成袢法、血管球囊辅助法行下腔静脉滤器取出术,22例从右侧颈内静脉进行,3例因右颈内静脉血栓或狭窄从左颈内静脉进行。结果 25例患者成功回收下腔静脉滤器,成功率100%。导丝成袢法取出17例;血管球囊辅助法取出8例;回收过程平均用时35.5 min(20~90 min)。滤器平均在体内留置时间为52 d(35~60 d),术后2 d全部患者顺利出院。结论对于Günther Tulip可回收式下腔静脉滤器严重倾斜致回收钩贴壁的疑难性病例,采用多种辅助性圈套技术可有效提高其回收率,具有一定的临床应用价值。
Objective To explore the technique and strategy of recovering Günther Tulip recoverable inferior vena cava filter through jugular vein. Methods From January 2012 to December 2014, the patients were placed in Günther Tulip recoverable inferior vena cava filter and were severely inclined. Twenty-five patients with hook-sticking wall were recovered and could not be recovered by conventional entrapment technique, including 17 males and 8 females. Age 27 to 72 years, mean age 56.2 years old. Guided by the guide wire method, vascular balloon assisted approach to remove the inferior vena cava filter, 22 cases from the right jugular vein, 3 cases of right internal jugular vein thrombosis or stenosis from the left internal jugular vein. Results 25 patients successfully recovered inferior vena cava filter, the success rate of 100%. Seventeen cases were removed with guide wire and eight cases with vascular balloon assisted method. The average recovery time was 35.5 minutes (20-90 minutes). On average, the filter was placed in the body for 52 days (35-60 days). All patients were discharged smoothly after 2 days. Conclusions For the difficult case of Günther Tulip recoverable inferior vena cava filter, which can lead to the recovery of hook adherent wall, many kinds of auxiliary trapping techniques can effectively increase the recovery rate and have certain clinical value.