中国临床保健杂志2026，Vol.29Issue(2)：167-171,5.DOI:10.3969/J.issn.1672-6790.2026.02.005
经颈内静脉-股静脉双向对拉技术回收超时间窗纺锤形下腔静脉滤器的安全性及有效性分析
Efficacy and safety of bilateral pull-back technique for the retrieval of overdue spindle-shaped inferior vena cava filters
蒋鹏 1曲诚家 1张蕴鑫 1李志存 1华润 1刘建龙1
作者信息
- 1. 国家骨科医学中心 首都医科大学附属北京积水潭医院血管外科,北京 100035
- 折叠
摘要
Abstract
Objective To evaluate the safety and clinical efficacy of a bilateral(jugular and femoral veins)pull-back technique for the retrieval of overdue spindle-shaped inferior vena cava filter(IVCF).Methods Clinical data of 19 patients with overdue spindle-shaped IVCF who underwent complex retrieval at Beijing Jishuitan Hospital Affiliated to Capital Medical University from September 2025 to January 2026 were retrospectively analyzed.All procedures utilized a combined internal jugular and common femoral vein approach.A through-and-through guidewire loop was established to provide stable,simultaneous bi-directional axial traction on the filter.A rigid/retrieval sheath was then advanced over the wire to mechanically dissect the neointimal hyperplasia adhering the filter struts to the caval wall.Technical success rate,filter dwell time,operative and fluoroscopy times,perioperative complications,and follow-up outcomes were recorded and analyzed.Results A total of 19 patients were included in this study.The middle filter dwell time was 50 d(range:27-420 d).The technical success rate of filter retrieval was 94.7％(18/19).The middle operative time was 56 min(range:25-210 min),the middle fluoroscopy time was 17 min(range:8-55 min).No major complications,such as inferior vena cava avulsion,fatal hemorrhage,or symptomatic pulmonary embolism,occurred in the successful cases.Minor complications(access site hematoma)occurred in one case and resolved with conservative management.During a middle postoperative follow-up period of 62 d,ultrasound/CT Venography re-examination revealed that the inferior vena cava remained patent in 14 patients.Conversely,in the 5 patients who initially presented with inferior vena cava occlusion during consultation,the occlusion persisted upon re-examination.Notably,none of the patients experienced recurrence of deep vein thrombosis.Conclusions For the spindle-shaped inferior vena cava filter with severe endothelialization and failed conventional retrieval beyond the time window,bidirectional pulling has good feasibility and safety.关键词
静脉血栓栓塞/腔静脉滤器/血管内操作/复发Key words
Venous thromboembolism/Vena cava filters/Endovascular procedures/Recurrence引用本文复制引用
蒋鹏,曲诚家,张蕴鑫,李志存,华润,刘建龙..经颈内静脉-股静脉双向对拉技术回收超时间窗纺锤形下腔静脉滤器的安全性及有效性分析[J].中国临床保健杂志,2026,29(2):167-171,5.
