肾静脉导丝定位在引导IVC滤器置入中的作用

目的 探讨肾静脉导丝定位的可行性及其在引导下腔静脉滤器(IVCF)置人中的作用.方法 对35例需要IVCF置入的患者行肾静脉导丝定位,确定IVCF放置位置,然后进行碘剂下腔静脉造影对照,判断定位的准确性和安全性.结果 造影证实35例患者导丝均成功进入双侧肾静脉,在肾静脉导丝定位引导下置入的IVCF头端距低位肾静脉下缘均在0～10 mm内;其中23例于2周后将滤器取出,1例因滤器上血栓大于3 mm未同收,2例因滤器下下腔静脉发现血栓未回收,其余9例因年龄大及患者拒绝末进行回收.随访1～22个月,无并发症发生.结论 肾静脉导丝定位在特殊情况下不失为一种较好的替代造影定位的方法.

The value of guide wire localization of renal veins to guide placement of inferior vena cava filter

Objective:To study the feasibility of localization of renal veins by guide wire and its value in guiding IVCF placement. Methods :In 35 adult patients with deep vein thrombosis (DVT) who required inferior vena cava filter (IVCF) placement, the renal veins were identified by guide wire, and then iodinated contrast cavography was done to determine the anatomy of the renal veins.The safety and accuracy of locailzation of renal veins by guide wire and iodinated contrast cavography prior to IVCF placement were compared. Results:Guide wire successfullly entered the renal veins, and was verified by positive-contrast vena cavography. IVCF was accurately and safely inserted in the right position guided by the wire in renal veins. The tip of filter which was placed by guiding of guide wire in renal veins, and IVCF laid in inferior vena cava at 0~10 mm below lower margin of renal vein, as verified by positive-contrast vena cavography. Twenty-three IVCFs were removed successfully two weeks later.Conclusions:In patients with contraindications to iodinated contrast material or ionizing radiation, localization of renal veins by guide wire is a safe and effective alternative to conventional positive-contrast vena cavography for guiding IVCF placement.