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심부정맥 혈전증의 도관유도 혈전용해술 또는 약물기계적 혈전제거술 후에 하대정맥 여과기 제거율과 임상적인 특징
노효근(Hyo Keun No),김중석(Joong Suck Kim),김장용(Jang Yong Kim),김경래(Kyung Rae Kim),신석환(Seok-Hwan Shin),안승익(Seung-Ik Ahn),조영업(Young Up Cho),김세중(Sei Joong Kim),이건영(Keon-Young Lee),허윤석(Yoon-Seok Hur),최선근(Sun Keu 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.6
Purpose: Inferior vena cava (IVC) filter is commonly practiced to prevent pulmonary embolism during endovascular therapy of deep vein thrombosis (EndoDVT). When the thrombus is trapped inside the filter during intervention, its removal is quite challenging. The purpose of this study is to determine retrieval rates of IVC filter after EndoDVT and its characteristics. Methods: Patients who underwent EndoDVT in Inha Unversity Hospital from June 2004 to May 2009 were reviewed retrospectively. Retrievable IVC filter was inserted before EndoDVT. EndoDVT was done by catheter directed thrombolysis or pharmacomechanical thrombectomy using urokinase. IVC filter retrieval was decided according to computed tomography after 2 weeks. Results: 126 patients were treated with EndoDVT. Optease (n=101) and Tulip (n=25) IVC filters were inserted. IVC filters were retrieved in 42.9% (54/126). There was no IVC filter related complication during its insertion and removal. IVC filter was not retrieved in 72 patients. Reasons for its failure include residual thrombosis in IVC filter (n=28), high risk for recurrent DVT (n=34), massive pulmonary embolism (n=8), and death (n=2). Residual thrombus inside IVC filter disappeared in 5 patients during 6-month follow up. Conclusion: IVC filters retrieval rate after EndoDVT was 42.9%. This can be improved by thorough patient follow up and extended retrievability.