Poster électronique

Faisabilité du retrait à long terme du filtre cave optionnel ALN
L. Bellmann (1), O. Pellerin (1), J. Goupil (2), O. Sanchez (1), J. Pineau (1), M. Sapoval (1) - (1) Paris - France, (2) Caen - France
Congrès 2010
Résumé
Objectifs
Evaluer la faisabilité de l’extraction par voie percutanée du filtre cave ALN plus de 1 an après son implantation.
Matériels et méthodes
Entre novembre 2004 et janvier 2010, un filtre optionnel (ALN ®, France) a été implanté chez 443 patients consécutifs. Quinze patients (âge moyen 55 ans et + / - 21,6 [26 - 86 ans]) ont été adressés pour l'extraction par voie percutanée après plus de 12 mois (en moyenne 25,6 mois [14,8 à 40,8 mois], 8 d’entre eux au delà de 2 ans). L'extraction du filtre a été tentée avec le kit dédié et en utilisant une voie d'abord jugulaire interne droite ou une double voie d'abord en associant la voie fémorale. Toutes les interventions ont été réalisées sous anesthésie locale.
Résultats
L'extraction a été réussie dans tous les cas. Aucune complication immédiate n’a été observée et les cavographies post-extraction ont montré une veine cave inférieure indemne, sans sténose, déchirure intimale ou dissection. Dans tous les cas, les examens macroscopique et microscopiques ont montré des traces de matériel embolique à l’intérieur du filtre, avec une petite quantité de débris de fibrine et moins de 10 % des cellules endothéliales.
Conclusion
Notre expérience tend à confirmer que ce filtre cave optionnel peut être retirer tardivement.
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