在一个学术医疗中心使用下静脉卡瓦过器的实践
Joud El Dick1, Palak Shah2, Asit Kr Paul2
1Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, USA.
Cureus
|April 4, 2024
概括
下静脉 (IVC) 过器经常由于非标准原因被放置,检索率低,随之而来的后续损失高. 需要改善教育和结构化的后续工作,以实现最佳的IVC过器使用.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 心脏病学 心脏病学
背景情况:
- 抗凝药是静脉血栓塞栓症 (VTE) 的标准.
- 当抗凝血药物禁用时,使用下腔静脉 (IVC) 过器.
- 除了禁忌之外,IVC过器的适用性证据有限.
研究的目的:
- 在当代患者系列中调查IVC过器的使用情况.
- 为了分析IVC过器放置的指示.
- 评估过器检索率和重新血栓形成事件.
主要方法:
- 在VCU医学中心 (2017-2018) 接受IVC过器的200名患者的回顾性审查.
- 收集关于人口统计,适应症,检索和再血栓形成的数据.
- 随访时间中位数为9个月.
主要成果:
- 65%的过器用于抗凝药的禁忌; 35%用于非标准指示.
- 46%的潜在合格患者的过器被移除了.
- 删除过器的8.1%和保留过器的3.4%发生了再血栓事件.
结论:
- 三分之一的IVC过器没有标准指示.
- 在一年内,不到一半的过器被移除.
- 随访的高损失 (32%) 需要改善患者和提供者教育和结构化的随访计划.
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