Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Effectiveness and Safety of the Tempofilter II to Prevent the Occurrence of Pulmonary Thromboembolism in Patients with Lower Extremity Deep Vein Thrombosis

하지 심부정맥혈전증 환자에서 폐동맥색전증을 예방하기 위한 Tempofilter II 설치술의 효율성과 안정성

  • Baek, Byung-Hyun (Department of Radiology, Chonnam National University Hospital, Chonnam National University, Medical School) ;
  • Jung, Min-Young (Department of Radiology, Chonnam National University Hospital, Chonnam National University, Medical School) ;
  • Oh, Hyun-Jun (Department of Radiology, Chonnam National University Hospital, Chonnam National University, Medical School) ;
  • Jang, Nam-Kyu (Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University, Medical School) ;
  • Kim, Jae-Kyu (Department of Radiology, Chonnam National University Hospital, Chonnam National University, Medical School) ;
  • Lee, Ho-Kyun (Department of Surgery, Chonnam National University Hospital, Chonnam National University, Medical School)
  • 백병현 (전남대학교 의과대학 영상의학교실) ;
  • 정민영 (전남대학교 의과대학 영상의학교실) ;
  • 오현준 (전남대학교 의과대학 영상의학교실) ;
  • 장남규 (화순전남대학교병원 영상의학과) ;
  • 김재규 (전남대학교 의과대학 영상의학교실) ;
  • 이호균 (전남대학교 의과대학 외과학교실)
  • Received : 2010.02.04
  • Accepted : 2010.05.11
  • Published : 2010.08.01
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Abstract

Purpose: To evaluate the efficacy and safety of the Tempofilter II for the prevention of a pulmonary thromboembolism (PTE) in patients with lower extremity deep vein thrombosis (DVT). Materials and Methods: Between January 2007 and December 2008, thirteen patients with lower extremity DVT whom were implanted with the Tempofilter II to prevent PTE were analyzed. A chest CT was compared before and after filter placement, to evaluate effectiveness of preventing PTE. Clinical symptoms of PTE were checked. Fluoroscopy and a plain radiograph were examined to evaluate filter status. Results: The tempofilter II was successfully inserted in 13 patients. Nine patients underwent endovascular treatment after filter insertion. Trapping of thrombus was evaluated by following CT, venography, and filter retrieval. Trapped thrombus was detected in four patients by CT or retrieved filter. Two patients showed a decrease in thrombus in a follow-up chest CT. Not all patients showed symptoms of PTE. One filter was surgically removed due to the detachment of the anchoring device. Conclusion: The placement and retrieval of the Tempofilter II is feasible and effective for the prophylaxis of PTE in patients with lower extremity DVT; especially for patients that underwent subsequent endovascular treatment.

목적: 하지 심부정맥혈전증 환자에서 폐동맥색전증을 예방하기 위한 Tempofilter II 설치술의 효과와 안정성을 알아보고자 하였다. 대상과 방법: 2007년 1월부터 2008년 12월까지 하지 심부정맥혈전증으로 폐동맥색전증을 예방하기 위해서 Tempofiltrer II를 설치 받은 13명을 대상으로 하였다. 폐동맥색전증 예방의 효과를 평가하기 위해 필터 설치 전후의 임상증상 변화를 관찰하였으며 흉부 CT의 변화를 확인하였다. 필터 자체의 평가에 투시와 단순 X-선 촬영이 이용되었다. 결과: 모든 예에서 성공적으로 Tempofilter II를 설치하였다. 필터 설치 후 9예는 혈관 내 중재술을 시행하였고 중재술 도중 혹은 추적 CT, 정맥조영술, 필터제거 시에 필터에 혈전의 걸림을 확인하였다. 중재술을 받은 9예 중 1예에서 추적 CT에서 필터에 혈전이 걸려 있었으며, 다른 3예는 필터 제거 시에 필터 내에 혈전이 관찰되었다. 필터를 삽입한 13예 모두 폐동맥색전증의 임상증상은 없었다. 합병증으로 1예에서 우측 경부 피하의 고정장치가 분리되어 수술적으로 필터를 제거하였다. 결론: 하지 심부정맥혈전증 환자에서 Tempofilter II의 설치 및 제거는 시술이 용이하였고, 특히 혈관 내 중재술을 하는 경우에 폐동맥색전증의 예방에 효과적이었다.

Keywords

References

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