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Management of Pulmonary Thromboembolism with Inferior Vena Cava Filter
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We managed a case in which an inferior vena cava filter was inserted for a pulmonary thromboembolism that occurred during general anesthesia. A 71-year-old woman was prepped for reduction of a distal femur fracture and arthroplastic surgery. Her initial vital signs were stable, but the end-tidal CO2 and SaO2 were decreased gradually after application of the tourniquet for surgery. Because of impaired ventricular wall motion and a dilated inferior vena cava on echocardiogram, we suspected a pulmonary thromboembolism. Thus, we inserted an inferior vena cava filter percutaneously under propofol sedation in the Radiology Department. In addition to ventilatory support and hemodynamic management, heparin was administered as anticoagulant therapy postoperatively in the intensive care unit. Multiple thrombi in the pulmonary artery were confirmed on chest CT. On the 4th postoperative day, she was transferred to the general ward without any complications.
Abstract
We managed a case in which an inferior vena cava filter was inserted for a pulmonary thromboembolism that occurred during general anesthesia. A 71-year-old woman was prepped for reduction of a distal femur fracture and arthroplastic surgery. Her initial vital signs were stable, but the end-tidal CO2 and SaO2 were decreased gradually after application of the tourniquet for surgery. Because of impaired ventricular wall motion and a dilated inferior vena cava on echocardiogram, we suspected a pulmonary thromboembolism. Thus, we inserted an inferior vena cava filter percutaneously under propofol sedation in the Radiology Department. In addition to ventilatory support and hemodynamic management, heparin was administered as anticoagulant therapy postoperatively in the intensive care unit. Multiple thrombi in the pulmonary artery were confirmed on chest CT. On the 4th postoperative day, she was transferred to the general ward without any complications.
참고문헌 (15)
- Kumar R, "Perioperative prophylaxis of venous thromboembolism", Am J Med Sci, 306, pp.336~344 (1993)
- Greenfield LJ, "Twenty-year clinical experience with the Greenfield filter", Cardiovasc Surg, 3, pp.199~205 (1995)
- Rogers FB, "Prophylactic vena cava filter insertion in severely injured trauma patients: indications and preliminary results", J Trauma, 35, pp.637~642 (1993)
- Janata-Schwatczek K, "Pulmonary embolism. II. Diagnosis and treatment", Semin Thromb Hemost, 22, pp.33~52 (1996)
- Heit JA, "Risk factors for venous thromboembolism", Clin Chest Med, 24, pp.1~12 (2003)
- Capan LM, "Monitoring for suspected pulmonary embolism", Anesthesiol Clin North America, 19, pp.673~703 (2001)
- Perrier A, "D-dimer testing for suspected pulmonary embolism in outpatients", Am J Respir Crit Care Med, 156, pp.492~496 (1997)
- Dehring DJ, "Pulmonary thromboembolism: disease recognition and patient management", Anesthesiology, 73, pp.146~164 (1990)
- Langan EM 3rd, "Prophylactic inferior vena cava filters in trauma patients at high risk: follow-up examination and risk", benefit assessment, 1999, pp.30, 484~488
- Becker DM, "Inferior vena cava filters. Indications, safety, effectiveness", Arch Intern Med, 152, pp.1985~1994 (1992)
- Offner PJ, "The role of temporary inferior vena cava filters in critically ill surgical patients", Arch Surg, 138, pp.591~594 (2003)
- Rosenthal D, "Retrievable inferior vena cava filters: early clinical experience", J Cardiovasc Surg, 46, pp.163~169 (2005)
- de Gregorio MA, "The Güunther Tulip retrievable filter: prolonged temporary filtration by repositioning within the inferior vena cava", J Vasc Interv Radiol, 14, pp.1259~1265 (2003)
- Asch MR, "Initial experience in humans with a new retrievable inferior vena cava filter", Radiology, 225, pp.835~844 (2002)
- Ferris EJ, "Percutaneous inferior vena caval filters: follow-up of seven designs in 320 patients", Radiology, 188, pp.851~856 (1993)