可检索下静脉卡瓦过器被困栓塞:血栓分离的风险因素 基于多中心前性观察研究的分析
Lei Zhang1, Wen-Ping Hu1,2, Hao Zhang1
1Department of Vascular Surgery, Changhai Hospital, Navy (Second) Military Medical University, Shanghai, China.
概括
下腔静脉过器可能会在患有下肢骨折或骨盆手术的患者中引起被困栓塞. 过器的放置并不总是必要的,特别是在老年患者或仅接受导管血栓溶解的患者中.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 预防肺栓塞 预防肺栓塞
背景情况:
- 下静脉膜过器 (IVCF) 放置的指示仍在讨论中.
- 血栓脱离和肺栓塞是显著的风险.
研究的目的:
- 确定血栓脱离的危险因素.
- 评估IVCF安置的必要性,以防止致命的肺栓塞.
主要方法:
- 多中心前性观察性研究,对2892名接受可检索IVCF (RIVCF) 放置的患者进行了研究.
- 主要终点:通过成像或宏观血栓检测到的RIVCF被困栓塞.
- 分析与RIVCF被困栓塞相关的因素.
主要成果:
- 10.65%的患者患有RIVCF被困栓塞.
- 在患有膝下/大腿骨折,骨盆手术和皮肤内机械血栓切除 + 导管导向血栓溶解 (PMT+CDT) 的患者中发生率更高.
- 在老年患者和仅接受CDT的患者中发生率较低.
结论:
- 下肢骨折,骨盆手术和PMT+CDT是被困栓塞的危险因素,表明致命的肺栓塞的可能性.
- 对于老年患者或仅仅使用CDT治疗的患者,IVCF安置可能不必要.
- 标准化IVCF使用和专注于高风险群体至关重要.
相关概念视频
Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
12
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
12
Venous Thrombosis I: Introduction
11
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
11
Hemodialysis I: Introduction
36
Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
36
Pulmonary Embolism I: Introduction
7
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
7


