Clinical Application of Inferior Vena Cava Filter
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摘要: 如今对于深静脉血栓形成患者,下腔静脉滤器(IVCF)的使用率持续增加,但其临床效益和远期并发症仍有很大争议,没有证据显示使用IVCF有生存获益性。尽管在临床实践中广泛使用IVCF,但在适应症方面各个地区却有很大差异。目前我们支持更为严格的美国胸科医师学院IVCF放置指征指南,只有在高危肺栓塞、围术期高出血风险并存在药物预防禁忌的情况下才考虑IVCF,并主张对可回收的IVCF进行密切而有组织的随访,一旦不再需要预防肺栓塞,尽快将其取出。本文全面对比了有关IVC过滤功效的随机性、前瞻性研究,比较美国和欧洲指南在IVCF适应证和并发症的差别。随着时间的推移,IVCF指南也在逐渐变化。Abstract: IVCF unilization ratio continues to increase in patients with deep venous thrombosis, but its clinical benefits and long-term complications remain controversial. There is no conclusive evidence of survival benefit with IVCF. It is widely used in clinical practice, but there are significant differences of indications in each area.We support the guidelines for placement of IVCF in the American College of Chest Physicians(ACCP), which use IVCF only in the setting of high-risk pulmonary embolism, high perioperative bleeding risk and contraindication for drug prevention.It needs to advocate a close follow-up of the recoverable IVCF. PE should be removed as soon as it is no longer needed.In this review, we provide a comprehensive comparison of randomized, prospective studies of IVCF efficacy. IVCF guidelines are also evolving.We compare the difference between IVCF indications and complications in the U.S. and European guidelines.
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